Provider Demographics
NPI:1962704833
Name:JONES, SUSAN FOSTER (DPT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:FOSTER
Last Name:JONES
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 1:4025 MCGINNIS FERRY RD
Mailing Address - Street 2:APT. 1114
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8315
Mailing Address - Country:US
Mailing Address - Phone:256-717-9234
Mailing Address - Fax:
Practice Address - Street 1:966A KILLIAN HILL RD SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3102
Practice Address - Country:US
Practice Address - Phone:770-923-4815
Practice Address - Fax:770-923-0901
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT10106225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist