Organization
SUTTLES FAMILY CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSA JANINE SUTTLES DC (OWNER)
(706) 340-7671
Entity
Organization
Contact information
Practice address
1441 HARTWELL HWY, ELBERTON, GA 30635-3405
(706) 340-7671
Mailing address
1012 EDWARDS DR, ELBERTON, GA 30635-4404
(706) 340-7671
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11614811
CAQH
GA
01
—
CHIR007885
STATE LICENSE
—
01
—
P01084237
PLAN NETWORK ID
GA
Enumeration date
06/21/2022
Last updated
12/30/2022
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