Provider Demographics
NPI:1427610922
Name:SUTHOFF, MAIREAD (ATC)
Entity type:Individual
Prefix:
First Name:MAIREAD
Middle Name:
Last Name:SUTHOFF
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MAIREAD
Other - Middle Name:
Other - Last Name:VIEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52 STONEGATE CT
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 CHRISTENDOM DR
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-6534
Practice Address - Country:US
Practice Address - Phone:540-671-3726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer