Individual
DR. TIMOTHY PAUL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
17000 E US HIGHWAY 40 STE 7, INDEPENDENCE, MO 64055-5394
(816) 373-6363
Mailing address
3506 HARVARD AVE, INDEPENDENCE, MO 64052-2337
(402) 490-7509
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2014013450
MO
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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