Organization
THE WOMEN'S DIET CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIS L. SULLIVAN M.D. (OWNER)
(256) 234-3477
Entity
Organization
Contact information
Practice address
3368 HIGHWAY 280, SUITE 111, ALEXANDER CITY, AL 35010-3393
(256) 234-3477
(256) 234-9866
Mailing address
3368 HIGHWAY 280, SUITE 111, ALEXANDER CITY, AL 35010-3393
(256) 234-3477
(256) 234-9866
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
AL
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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