Individual
PETER C SULACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
11151 KINGSTON PIKE, SUITE C, KNOXVILLE, TN 37934-2853
(865) 675-2050
(865) 675-2051
Mailing address
11151 KINGSTON PIKE, SUITE C, KNOXVILLE, TN 37934-2853
(865) 675-2050
(865) 675-2051
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC0000001857
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4033747
BCBS BILLING PROVIDER #
TN
01
—
4033748
BCBS RENDERING PROVIDER #
TN
Enumeration date
08/08/2006
Last updated
07/08/2007
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