Individual
DR. AMANDA ANNE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 E SUNSET DR, WAUKESHA, WI 53189-7816
(262) 899-6010
Mailing address
1441 S 65TH ST APT 104, WEST ALLIS, WI 53214-4987
(708) 369-9081
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19520-40
WI
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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