| NPI | 1679529788 |
|---|---|
| Professional Name | KENNETH JAMES SULLIVAN-BOL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VT 006.0061495) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 38-009348) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: VT 006.0061495) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-04-24 |