Provider Demographics
NPI:1982654943
Name:SUTO, JOHN S (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:SUTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:OR
Mailing Address - Zip Code:97828-1427
Mailing Address - Country:US
Mailing Address - Phone:541-426-3107
Mailing Address - Fax:541-426-6437
Practice Address - Street 1:610 W NORTH ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:OR
Practice Address - Zip Code:97828-1427
Practice Address - Country:US
Practice Address - Phone:541-426-3107
Practice Address - Fax:541-426-6437
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3298OR111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR111211Medicare PIN
ORU40465Medicare UPIN