Individual
ASHLEY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT MMP
Contact information
Practice address
3041 MELROSE AVE, CAPE GIRARDEAU, MO 63701
(573) 382-6734
Mailing address
3041 MELROSE AVE, CAPE GIRARDEAU, MO 63701
(573) 382-6734
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2010024803
MO
225700000X
Massage Therapist
227.013038
IL
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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