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Individual

BRUCE F SULLENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
14700 EAST OLD US 12, CHELSEA, MI 48118-1185
(734) 475-1321
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003720
MI
363AM0700X
Medical Physician Assistant
5601003720
MI

Other

Enumeration date
10/24/2006
Last updated
03/25/2011
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