Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301008559 | MI |
NPI | 1013032143 |
---|---|
Provider Name | Dr. Misty Danshinhee Sutton |
First Address | Millington, MI 48746-9665 |
Second Address | Millington, MI 48746-9665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U97640 | (02) | MI |