Matthew R Sullivan Od PC

NPI #1285813360 in Prescott, Arizona

Provider Information

NPI Number: 1285813360
Entity Type: Organization
Organization Name: Matthew R Sullivan Od PC
Primary Specialty: Optometrist
Enumeration Date: Oct 25, 2007
Last Updated: Mar 30, 2021

Practice Location

Address: 980 WILLOW CREEK ROAD
Address 2: SUITE 202
City: Prescott
State: Arizona
ZIP Code: 86301
Phone: (928) 778-3937

Authorized Official

Name: TRACY HOLMES SULLIVAN
Title: OFFICE MANAGER
Phone: (928) 778-3937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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