Individual
MISS ANDREA MARIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANDREA SULLIVAN
Contact information
Practice address
2150 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-5029
(651) 230-1629
Mailing address
232 SNELLING AVE S, SAINT PAUL, MN 55105-1944
(651) 230-1629
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20090000761
MN
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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