| NPI | 1043670375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER SULLIVAN Lead Physician 502-724-0263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NJ 38MC00718600) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-02-29 |