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NPI Code Detail

MEDICARE: DR. DENNIS MICHAEL SULLIVAN D.C.

MEDICARE:  DR. DENNIS MICHAEL SULLIVAN  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor27-2247OR

General Provider Information

NPI Number : 1073552873
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENNIS MICHAEL SULLIVAN D.C.
Provider Business Mailing Address
First Line : 2305 SE WASHINGTON ST
Second Line : SUITE 109
City : MILWAUKIE
State : OR
Zip : 97222-7647
Country : US
Telephone Number : 503-659-0064
Fax Number : 503-659-0445
Provider Business Practice Location Address
First Line : 2305 SE WASHINGTON ST
Second Line : SUITE 109
City : MILWAUKIE
State : OR
Zip : 97222-7647
Country : US
Telephone Number : 503-659-0064
Fax Number : 503-659-0445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 06/08/2011

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Directions to “ DR. DENNIS MICHAEL SULLIVAN D.C.” Practice Location

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