Doctor Name: | MR. P. ALEXANDER SULLIVAN |
NPI Number: | 1871647099 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.T. 2569 |
License Number: | #2569 |
Business Practice Address: | 1210 Luisa St Ste 9 Santa Fe, NM - 875054175 |
Business Phone Number: | 5055014263 |
Business Fax Number: | 5055014263 |
Mailing Address: | 1210 Luisa St Ste 9, SANTA FE |
State: | NM |
Postal Code: | 875054175 |
Phone Number: | 5055014263 |
Fax Number: | 5055014263 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 11/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | #2569 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |