Individual
DR. GREGORY L SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3900 GRAVOIS AVE, SAINT LOUIS, MO 63116-3621
(314) 664-9500
(314) 664-9501
Mailing address
3900 GRAVOIS AVE, SAINT LOUIS, MO 63116-3621
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5553
MO
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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