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General NPI Number Information
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NPI Number | 1013100510
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Entity Type | Organization
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Legal Business Name | MICHAEL W SULLIVAN, DC
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 601 ALAMEDA ST
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City | NORMAN
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State | OK
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Zip | 73071-5455
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Country | US
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Telephone | 405-447-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 601 ALAMEDA ST
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City | NORMAN
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State | OK
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Zip | 73071-5455
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Country | US
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Telephone | 405-447-5181
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL W SULLIVAN
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Credential | D.C.
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Telephone | 405-447-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3224
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License Number State | OK
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