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Individual

MR. DARYLE SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.M.T.

Contact information

Practice address
9501 STATE AVE, SUITE A, MARYSVILLE, WA 98270-2235
(360) 651-8264
(360) 658-9021
Mailing address
9501 STATE AVE, SUITE A, MARYSVILLE, WA 98270-2235
(360) 651-8264
(360) 658-9021

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00008878
WA
225700000X
Massage Therapist
MT110567
TX

Other

Enumeration date
09/23/2013
Last updated
09/23/2013
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