Individual
ROBERT SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT-A
Contact information
Practice address
30 BELMONT RD, HERNANDO, MS 38632-7601
(662) 671-3712
Mailing address
30 BELMONT RD, HERNANDO, MS 38632-7601
(662) 671-3712
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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