Individual
KRISTIN S SULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
210 BOB WALLACE AVE SW, HUNTSVILLE, AL 35801-3809
(256) 539-3454
Mailing address
210 BOB WALLACE AVE SW, HUNTSVILLE, AL 35801-3809
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
SB64
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SB64
STATE LICENSE
—
Enumeration date
09/18/2007
Last updated
02/20/2008
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