Organization
REVITALIZE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY JOHN SULLIVAN DC (CHIROPRACTOR)
(402) 592-7686
Entity
Organization
Contact information
Practice address
8013 L ST, OMAHA, NE 68127
(402) 592-7686
(402) 592-0689
Mailing address
8013 L ST, OMAHA, NE 68127
(402) 592-7686
(402) 592-0689
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1726
NE
Other
Enumeration date
09/12/2012
Last updated
01/23/2013
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