Individual
GREG SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2140 E DOROTHY LN, KETTERING, OH 45420-1114
(937) 395-0633
Mailing address
2140 E DOROTHY LN, KETTERING, OH 45420-1114
(937) 395-0633
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03316729
OH
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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