Provider Demographics
NPI:1891118253
Name:SUTTON, DANIEL P (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:SUTTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BEVINS LN
Mailing Address - Street 2:SUITE F
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-6128
Mailing Address - Country:US
Mailing Address - Phone:502-863-4242
Mailing Address - Fax:
Practice Address - Street 1:208 BEVINS LN
Practice Address - Street 2:SUITE F
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-6128
Practice Address - Country:US
Practice Address - Phone:502-863-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004998225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist