Individual
DR. DONALD CRAIG SULLTROP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1590 WILLOW CREEK RD, PRESCOTT, AZ 86301
(928) 227-1899
Mailing address
1590 WILLOW CREEK RD, PRESCOTT, AZ 86301-1164
(928) 227-1899
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
22179
CA
111N00000X
Chiropractor
5182
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860982594
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
12/31/2007
Last updated
03/06/2017
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