MEDICARE: DR. SUZANNA MASSEY, INC.

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	DC.1917	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407198260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SUZANNA MASSEY, INC.

Provider Business Mailing Address
First Line	:	2179 S TAYLOR RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3012
Country	:	US
Telephone Number	:	216-371-6200
Fax Number	:	216-371-1410

Provider Business Practice Location Address
First Line	:	2179 S TAYLOR RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3012
Country	:	US
Telephone Number	:	216-371-6200
Fax Number	:	216-371-1410

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SUZANNA MASSEY
Credential	:	D.C.
Telephone Number	:	216-371-6200

Provider Enumeration Date	:	03/20/2013
Last Update Date	:	03/20/2013

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