Individual
JOHN PETER SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 CALLE DEL MEDIA, TIJERAS, NM 87059-7421
(832) 865-2880
Mailing address
16 CALLE DEL MEDIA, TIJERAS, NM 87059-7421
(832) 865-2880
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007398
NM
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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