Provider Demographics
NPI:1447361084
Name:IVIE, SUZANNE (DC)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:IVIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 FOXON RD
Mailing Address - Street 2:UNIT 8
Mailing Address - City:NORTH BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06471-1287
Mailing Address - Country:US
Mailing Address - Phone:203-484-7579
Mailing Address - Fax:203-484-2686
Practice Address - Street 1:999 FOXON RD
Practice Address - Street 2:UNIT 8
Practice Address - City:NORTH BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06471-1287
Practice Address - Country:US
Practice Address - Phone:203-484-7579
Practice Address - Fax:203-484-2686
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor