Provider Demographics
NPI:1346611456
Name:SUITOR, JEREMY (PT, DPT OCS)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:SUITOR
Suffix:
Gender:M
Credentials:PT, DPT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 KENDRICK ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-1184
Mailing Address - Country:US
Mailing Address - Phone:989-721-2002
Mailing Address - Fax:
Practice Address - Street 1:1838 KENDRICK ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-1184
Practice Address - Country:US
Practice Address - Phone:989-721-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017428225100000X
TX1267366225100000X
CAPT291877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist