Individual
ISSIAH THOMAS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
901 N JUPITER RD STE 110, RICHARDSON, TX 75081-3243
(469) 330-2225
Mailing address
2721 ABRAMS RD, DALLAS, TX 75214-3311
(817) 371-9589
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13746
TX
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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