Michael Ashby Sullivan

NPI #1972114882 in Stafford, Virginia

Provider Information

NPI Number: 1972114882
Entity Type: Individual
Name: Michael Ashby Sullivan
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Aug 13, 2020
Last Updated: Aug 13, 2020

Practice Location

Address: 2152 JEFFERSON DAVIS HWY
City: Stafford
State: Virginia
ZIP Code: 22554-7273
Phone: (540) 751-8750

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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