MEDICARE: MITCHELL WADE SUTTER DC

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	2020015015	MO

General Provider Information

NPI Number	:	1871133272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL WADE SUTTER DC

Provider Business Mailing Address
First Line	:	7 MELGROVE LN STE 101
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-2275
Country	:	US
Telephone Number	:	573-248-1393
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 MELGROVE LN STE 101
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-2275
Country	:	US
Telephone Number	:	573-248-1393
Fax Number	:

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

Provider Enumeration Date	:	01/14/2020
Last Update Date	:	06/30/2026

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Directions to “ MITCHELL WADE SUTTER DC” Practice Location

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