Provider Demographics
NPI:1013032143
Name:SUTTON, MISTY DANSHINHEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MISTY
Middle Name:DANSHINHEE
Last Name:SUTTON
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 1:8758 STATE RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48746-9665
Mailing Address - Country:US
Mailing Address - Phone:989-871-4733
Mailing Address - Fax:989-871-4572
Practice Address - Street 1:8758 STATE RD
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:MI
Practice Address - Zip Code:48746-9665
Practice Address - Country:US
Practice Address - Phone:989-871-4733
Practice Address - Fax:989-871-4572
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU97640Medicare UPIN
MIN80490002Medicare ID - Type Unspecified