Mack, Susan

Mack, Susan is an individual health care provider with primary practice located at 4016 Raintree Rd Suite 240, Chesapeake VA 23321-3700. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Mack, Susan can be contacted via phone (757) 488-2864.

Contact Information

Primary practice address
4016 Raintree Rd Suite 240 Chesapeake VA 23321-3700
Phone: (757) 488-2864
Fax: (757) 488-4735
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 0119004459 Virginia

Profile Details

NPI number 1356596217
LBN Legal business name Mack, Susan
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2008
Last updated Nov 19th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1356596217 NPPES
Virginia MEDICAID 004979061

Popular Providers