MEDICARE: JOHN E SUTHERLAND DC 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

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	:	1750484333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN E SUTHERLAND DC INC

Provider Business Mailing Address
First Line	:	1825 N REYNOLDS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615
Country	:	US
Telephone Number	:	419-537-6669
Fax Number	:	419-537-0144

Provider Business Practice Location Address
First Line	:	1825 N REYNOLDS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615
Country	:	US
Telephone Number	:	419-537-6669
Fax Number	:	419-537-0144

Authorized Official
Title or Position	:	CHIROPRACTOR OWNER
Name	:	JOHN E SUTHERLAND
Credential	:
Telephone Number	:	419-537-6669

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	10/30/2007

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