Provider Demographics
NPI:1679814917
Name:KLUTING, SUZANNE C (CO)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:C
Last Name:KLUTING
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:JOTZAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CO
Mailing Address - Street 1:720 MICHIGAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-6901
Mailing Address - Country:US
Mailing Address - Phone:616-396-4620
Mailing Address - Fax:
Practice Address - Street 1:720 MICHIGAN AVE STE B
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-6901
Practice Address - Country:US
Practice Address - Phone:616-396-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist