Provider Demographics
NPI:1114235546
Name:SUTTON, ERIKA (PT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:KUKLEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 W HIGHWAY 6 STE 101
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7545
Mailing Address - Country:US
Mailing Address - Phone:254-776-3070
Mailing Address - Fax:254-776-7909
Practice Address - Street 1:611 W HWY 6
Practice Address - Street 2:SUITE 101
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7544
Practice Address - Country:US
Practice Address - Phone:254-776-3070
Practice Address - Fax:254-776-7909
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12003722251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic