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Individual

MR. BRIAN KEITH SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MT

Contact information

Practice address
326 STARBRIDGE RD, MURRAYVILLE, GA 30564-2817
(706) 265-9530
(706) 867-7969
Mailing address
396 STARBRIDGE RD, MURRAYVILLE, GA 30564-2817
(706) 265-9530
(706) 867-7969

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005008
GA

Other

Enumeration date
04/10/2012
Last updated
04/10/2012
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