Individual
JEFFREY P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 752-1761
(406) 756-3528
Mailing address
1261 FOXTAIL DR, KALISPELL, MT 59901-7795
(406) 755-8612
(406) 756-3528
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
15036
NV
183500000X
Pharmacist
2958
WY
183500000X
Pharmacist
Primary
5811
MT
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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