Individual
TAYLOR MCKENZIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 HIGHWAY 52 BYP W, LAFAYETTE, TN 37083-1758
(615) 666-2135
(615) 666-2135
Mailing address
402 REXS LN, LAFAYETTE, TN 37083-3565
(615) 670-0121
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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