Provider Demographics
NPI:1205040821
Name:SUTTON, LON ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:LON
Middle Name:ERIC
Last Name:SUTTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 E LINE ST
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-3502
Mailing Address - Country:US
Mailing Address - Phone:760-873-5561
Mailing Address - Fax:
Practice Address - Street 1:218 E LINE ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-3502
Practice Address - Country:US
Practice Address - Phone:760-873-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor