Provider Demographics
NPI:1275683153
Name:CORRE-SULLIVAN, DONNA ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:ANNE
Last Name:CORRE-SULLIVAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 STARBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MURRAYVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30564-2817
Mailing Address - Country:US
Mailing Address - Phone:706-864-0882
Mailing Address - Fax:706-867-7969
Practice Address - Street 1:326 STARBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MURRAYVILLE
Practice Address - State:GA
Practice Address - Zip Code:30564-2817
Practice Address - Country:US
Practice Address - Phone:706-864-0882
Practice Address - Fax:706-867-7969
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR001496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor