Gary Sullivan

NPI #1063862464 in Festus, Missouri

Provider Information

NPI Number: 1063862464
Entity Type: Individual
Name: Gary Sullivan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Jun 16, 2016
Last Updated: Jun 16, 2016

Practice Location

Address: 110 N MILL ST
City: Festus
State: Missouri
ZIP Code: 63028-1816
Phone: (636) 931-2700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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