Individual
KEVIN MICHAEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 706-1256
(270) 706-1258
Mailing address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 706-1256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010988
KY
Other
Enumeration date
06/07/2022
Last updated
06/14/2022
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