Individual
PENNY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BENEFIT CORD
Contact information
Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-3507
Mailing address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-3507
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
440552485
MO
Other
Enumeration date
11/14/2024
Last updated
11/14/2024
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