NPI | 1659460707 |
---|---|
Former Name | MELISSA ELEEN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: KY 4275) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 1942) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2007-07-08 |