Provider Demographics
NPI:1871862995
Name:CLOTHIER, SUSANN H (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSANN
Middle Name:H
Last Name:CLOTHIER
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 1:31 RANCH VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-2856
Mailing Address - Country:US
Mailing Address - Phone:716-912-9666
Mailing Address - Fax:585-319-4376
Practice Address - Street 1:503 BEAHAN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-3403
Practice Address - Country:US
Practice Address - Phone:716-912-9666
Practice Address - Fax:585-319-4376
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00696700111N00000X
NY012065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00696700Other38MC00696700