Individual
CHRISTINE LOUISE SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3161 MAIN ST, EAST TROY, WI 53120-1151
(262) 642-7404
(262) 642-7493
Mailing address
PO BOX 645, EAST TROY, WI 58120-0645
(262) 642-7404
(262) 642-7493
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3767012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38931300
—
WI
Enumeration date
03/14/2006
Last updated
07/08/2007
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