MEDICARE: DR. SUSAN DU TOIT D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	6541	TX

General Provider Information

NPI Number	:	1912111287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN DU TOIT D.C.

Provider Business Mailing Address
First Line	:	265 CEDAR LN
Second Line	:
City	:	CEDAR CREEK
State	:	TX
Zip	:	78612-3216
Country	:	US
Telephone Number	:	512-296-6871
Fax Number	:	512-303-1239

Provider Business Practice Location Address
First Line	:	265 CEDAR LN
Second Line	:
City	:	CEDAR CREEK
State	:	TX
Zip	:	78612-3216
Country	:	US
Telephone Number	:	512-296-6871
Fax Number	:	512-303-1239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	01/15/2012

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