Individual
MARY RYAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
119 DAGGETT DR, WEST SPRINGFIELD, MA 01089-4672
(413) 747-5524
(413) 731-5430
Mailing address
119 DAGGETT DR, WEST SPRINGFIELD, MA 01089-4672
(413) 747-5524
(413) 731-5430
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21679
MA
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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