Provider Demographics
NPI:1962240911
Name:SKELTON, SUZAN ELIZABETH (DPT)
Entity type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:ELIZABETH
Last Name:SKELTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-6536
Mailing Address - Country:US
Mailing Address - Phone:940-594-5910
Mailing Address - Fax:
Practice Address - Street 1:1600 FLORIDA RD STE 1
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6836
Practice Address - Country:US
Practice Address - Phone:970-259-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPLT.0019908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist