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Individual

ELISHIA KAY SUTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 STEWART RD, MONROE, MI 48162-5304
(734) 240-1820
Mailing address
1421 N NISSEN RD, MARTIN, OH 43445-9714

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016579
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1417460361
MI
Enumeration date
11/14/2017
Last updated
12/04/2018
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