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General NPI Number Information
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NPI Number | 1548150733
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Entity Type | Organization
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Legal Business Name | SULLIVAN CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 11405 N PENN ST
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City | CARMEL
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State | IN
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Zip | 46032-6942
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Country | US
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Telephone | 317-343-6904
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 SILVER PINE LN
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City | SHERIDAN
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State | IN
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Zip | 46069-1394
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Country | US
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Telephone | 320-808-7980
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | HEIDI SULLIVAN
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Credential | DC
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Telephone | 317-343-6904
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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 |
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License Number State |
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