Individual
CRAIG P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1830 STATE HIGHWAY 9, DECORAH, IA 52101-7301
(563) 382-2931
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
468
IA
213EP1101X
Primary Podiatric Medicine Podiatrist
628
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43212300
—
WI
Enumeration date
06/14/2005
Last updated
06/04/2015
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