Provider Demographics
NPI:1982058228
Name:DUTTON, CASSANDRA MARIA (DC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MARIA
Last Name:DUTTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:MARIA
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:12044 SPRING RD SW
Mailing Address - Street 2:
Mailing Address - City:PILLAGER
Mailing Address - State:MN
Mailing Address - Zip Code:56473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7350 CLEARWATER RD
Practice Address - Street 2:3201
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425
Practice Address - Country:US
Practice Address - Phone:218-454-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-22
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor