Provider Demographics
NPI:1184926412
Name:SUCHEY, BRANDON JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:JOSEPH
Last Name:SUCHEY
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:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-0707
Mailing Address - Country:US
Mailing Address - Phone:989-348-4560
Mailing Address - Fax:989-348-1663
Practice Address - Street 1:122 E MICHIGAN AVE # 707
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-1741
Practice Address - Country:US
Practice Address - Phone:989-348-4560
Practice Address - Fax:989-348-1663
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4151596Medicaid
MI0B00032OtherBLUE CROSS BLUE SHIELD GROUP PIN