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Contact Information

SUSAN L BOOTH
4451A MAHONING AVE
WARREN, OH44483
 Phone: 330-847-0919
 Fax: 330-847-0728
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for SUSAN L BOOTH · (Female)

NPI # 1063434892
Status Active
Credentials
Entity Individual
Enumeration date 07/24/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 3399
  • OH Medicaid 2083169
  • OH Other 000000168546 ANTHEM GROUP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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