MRS. Susan Renae Ingram, LPTA

NPI #1427693126 in Flora, Illinois

Provider Information

NPI Number: 1427693126
Entity Type: Individual
Name: MRS. Susan Renae Ingram, LPTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: LPTA
Enumeration Date: Nov 17, 2019
Last Updated: Nov 21, 2019

Practice Location

Address: 911 STACEY BURK DR
City: Flora
State: Illinois
ZIP Code: 62839-3241
Phone: (618) 292-4655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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