Individual
BENJAMIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
208 RACE ST # 16, HOLYOKE, MA 01040-5724
(413) 315-6353
Mailing address
420 RACE ST, HOLYOKE, MA 01040-5574
(413) 334-8897
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
01/13/2024
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