Organization
SULLIVAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A SULLIVAN (OWNER)
(715) 375-2579
Entity
Organization
Contact information
Practice address
8787 E BEBE RD, SOLON SPRINGS, WI 54873-8122
(715) 375-2579
(715) 375-2579
Mailing address
8787 E BEBE RD, SOLON SPRINGS, WI 54873-8122
(715) 375-2579
(715) 375-2579
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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