Healthcare Provider Details

I. General information

NPI: 1659347227
Provider Name (Legal Business Name): JESSE SUTTON HIRONYMOUS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 WINDCHIME PL
COLORADO SPRINGS CO
80919-1984
US

IV. Provider business mailing address

8011 WATERVALLEY RD
COLORADO SPRINGS CO
80920-8025
US

V. Phone/Fax

Practice location:
  • Phone: 713-962-5356
  • Fax:
Mailing address:
  • Phone: 713-962-5356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number06903
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number06903
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06903
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: