Individual
DR. MARTIN ANTHONY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4969 ROSWELL RD STE 100-105, ATLANTA, GA 30342-2678
(404) 255-3110
Mailing address
1295 DRESDEN DR NE UNIT 126, BROOKHAVEN, GA 30319-3748
(850) 598-1119
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CHIRO10176
GA
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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