Provider Demographics
NPI:1427242908
Name:SEARFOSS, SUSAN RAE (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RAE
Last Name:SEARFOSS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:RAE
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:211 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2859
Mailing Address - Country:US
Mailing Address - Phone:319-277-3166
Mailing Address - Fax:319-266-4846
Practice Address - Street 1:211 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2859
Practice Address - Country:US
Practice Address - Phone:319-277-3166
Practice Address - Fax:319-266-4846
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665380Medicaid
IAJ00301OtherUHC RIVER VALLEY
IAJ00301OtherUHC RIVER VALLEY