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Individual

MR. JAMES WILLIAM SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC, LMT

Contact information

Practice address
2745 HIGH RIDGE BLVD STE 7, HIGH RIDGE, MO 63049-2200
(314) 825-4432
Mailing address
2745 HIGH RIDGE BLVD STE 7, HIGH RIDGE, MO 63049-2200
(314) 825-4432

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
2011001342
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232812942
SAINT LOUIS BEHAVIORAL MEDICINE INSTITUTE
MO
Enumeration date
04/15/2011
Last updated
09/02/2014
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