Healthcare Provider Details

I. General information

NPI: 1720405137
Provider Name (Legal Business Name): SAMANTHA JO BEUTLER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N MAIN ST STE 1
MT PLEASANT MI
48858-1500
US

IV. Provider business mailing address

625 N MAIN ST
MT PLEASANT MI
48858-1500
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-2534
  • Fax:
Mailing address:
  • Phone: 989-773-2534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010195
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: