Provider Demographics
NPI:1538244637
Name:SUSSMAN, NORMAN (DC)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:SUSSMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 SOUTHWOOD BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:INCLINE VILLAGE
Mailing Address - State:NV
Mailing Address - Zip Code:89451-9448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:785 SOUTHWOOD BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:INCLINE VILLAGE
Practice Address - State:NV
Practice Address - Zip Code:89451-9448
Practice Address - Country:US
Practice Address - Phone:775-831-8080
Practice Address - Fax:775-831-8081
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01176111N00000X
MA2118111N00000X
CADC-30027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor