Individual
DR. MICHAEL JAMES SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
59 ELM ST, POTSDAM, NY 13676-1808
(315) 265-7417
(315) 265-7417
Mailing address
125 MARTIN AVE. WEST, WINNIPEG, MANITOBA R2L 0-B3
(204) 663-8744
(204) 663-6412
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007119-1
NY
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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