Individual
BENJAMIN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 233-7232
Mailing address
126 WARWICK CT, ELYRIA, OH 44035-4667
(440) 412-6142
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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