Individual
LYNETTE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2003 BROADWAY ST, ANDERSON, IN 46012-1602
(765) 643-1515
Mailing address
2003 BROADWAY ST, ANDERSON, IN 46012-1602
(765) 643-1515
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017580A
IN
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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