MEDICARE: DR. SUZANNE ELIZABETH PLANO 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	CR1406	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022385	OTHER	ME	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295824191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE ELIZABETH PLANO D.C.

Provider Business Mailing Address
First Line	:	22 FOX RIDGE RUN
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073
Country	:	US
Telephone Number	:	207-653-1738
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 MAIN ST
Second Line	:	SUITE 2
City	:	SPRINGVALE
State	:	ME
Zip	:	04083-1818
Country	:	US
Telephone Number	:	207-490-1530
Fax Number	:	207-490-1530

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2008

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