Most Relevant Information
Provider Data
| NPI Number: | 1003039660 |
| Provider Name: | SUSANA CHACON OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | OT001387 |
Most Important Dates
| Enumeration Date: | 04/11/2007 |
| Last Updated: | 05/18/2023 |
Provider Practice Location
516 GRANT AVE
NORTH AUGUSTA
SC
298413632
Practice Location Phone/Fax
| Phone: | 7068252996 |
| Fax: | 8552328604 |
Provider Mailing Location
516 GRANT AVE
NORTH AUGUSTA
SC
298413632
Provider Mailing Phone/Fax
| Phone: | 7068252996 |
| Fax: | 8552328604 |