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General NPI Number Information
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NPI Number | 1811399413
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Entity Type | Individual
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Provider Name | MEGAN R. SULLIVAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 278 W. DOUGLAS AVE
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City | WICHITA
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State | KS
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Zip | 67203-6104
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Country | US
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Telephone | 316-267-2555
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Fax | 316-267-2554
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Provider Business Mailing Address
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Address Line | 360 S ALL HALLOWS ST
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City | WICHITA
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State | KS
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Zip | 67213-2438
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Country | US
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Telephone | 785-214-2514
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Fax | 316-201-4331
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 01-05658
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License Number State | KS
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