Individual
MARY B SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1138 W C ST, TORRINGTON, WY 82240-3371
(307) 532-6296
(307) 532-8519
Mailing address
PO BOX 314, TORRINGTON, WY 82240-0314
(307) 532-6296
(307) 532-8519
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2009
Last updated
01/06/2010
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