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Individual

MICHAEL SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
20427 N 27TH AVE, PHOENIX, AZ 85027-3241
(623) 869-6100
Mailing address
20427 N 27TH AVE, PHOENIX, AZ 85027-3241

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023035
AZ

Other

Enumeration date
09/10/2017
Last updated
09/10/2017
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