Four-Ten Enterprise, LLC

NPI #1619497401 in Tyler, Texas

Provider Information

NPI Number: 1619497401
Entity Type: Organization
Organization Name: Four-Ten Enterprise, LLC
Primary Specialty: Chiropractor
Enumeration Date: Jun 22, 2017
Last Updated: Jan 17, 2023

Practice Location

Address: 1540 RICE RD STE 400
City: Tyler
State: Texas
ZIP Code: 75703-3223
Phone: (903) 597-9021

Authorized Official

Name: JIMMY BRIAN SULLIVAN, DC
Title: OWNER
Phone: (903) 597-9021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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