MEDICARE: DR. JOHN S SUTO 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	111NS0005X	Sports Physician Chiropractor	3298OR	OR

General Provider Information

NPI Number	:	1982654943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN S SUTO D.C.

Provider Business Mailing Address
First Line	:	610 W NORTH ST
Second Line	:
City	:	ENTERPRISE
State	:	OR
Zip	:	97828-1427
Country	:	US
Telephone Number	:	541-426-3107
Fax Number	:	541-426-6437

Provider Business Practice Location Address
First Line	:	610 W NORTH ST
Second Line	:
City	:	ENTERPRISE
State	:	OR
Zip	:	97828-1427
Country	:	US
Telephone Number	:	541-426-3107
Fax Number	:	541-426-6437

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	05/13/2019

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Directions to “ DR. JOHN S SUTO D.C.” Practice Location

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