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Individual

DR. TYLER BLAKE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1000 S LIMESTONE, LEXINGTON, KY 40536-0001
(859) 257-1000
Mailing address
3532 CREEKWOOD DR APT 17, LEXINGTON, KY 40502-6517
(606) 794-4785

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
024748
KY

Other

Enumeration date
10/31/2024
Last updated
10/31/2024
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