Organization
SULLIVAN CHIROPRACTIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS WAYNE SULLIVAN D.C. (OWNER)
(785) 691-7325
Entity
Organization
Contact information
Practice address
1309 W 6TH ST STE A, LAWRENCE, KS 66044-2220
(785) 856-2250
(785) 856-2242
Mailing address
1309 W 6TH ST STE A, LAWRENCE, KS 66044-2220
(785) 856-2250
(785) 856-2242
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
01-05275
KS
305R00000X
Preferred Provider Organization
Primary
01-05275
KS
305S00000X
Point of Service
01-05275
KS
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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