Basic Information
| Provider Information | |||||||||
| NPI: | 1962704833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | FOSTER | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4025 MCGINNIS FERRY RD | ||||||||
| Address2: | APT. 1114 | ||||||||
| City: | SUWANEE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300248315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567179234 | ||||||||
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| Practice Location | |||||||||
| Address1: | 966A KILLIAN HILL RD SW | ||||||||
| Address2: | |||||||||
| City: | LILBURN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300473102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709234815 | ||||||||
| FaxNumber: | 7709230901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2010 | ||||||||
| LastUpdateDate: | 11/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT10106 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.