Healthcare Provider Details

I. General information

NPI: 1730680133
Provider Name (Legal Business Name): REBECCA SUTPHIN DC, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1071 PEMBERTON HILL RD STE 201
APEX NC
27502-4268
US

IV. Provider business mailing address

7808 GLENHARDEN DR
RALEIGH NC
27613-1521
US

V. Phone/Fax

Practice location:
  • Phone: 919-909-1095
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4814
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: