Provider Demographics
NPI:1295824191
Name:PLANO, SUZANNE ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:PLANO
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 1:22 FOX RIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073
Mailing Address - Country:US
Mailing Address - Phone:207-653-1738
Mailing Address - Fax:
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1818
Practice Address - Country:US
Practice Address - Phone:207-490-1530
Practice Address - Fax:207-490-1530
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME022385OtherBC/BS
ME403900099Medicaid
ME403900099Medicaid