Organization
THEODORE K SULLIVAN, OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE K SULLIVAN OD (OPTOMETRIST)
(314) 478-3669
Entity
Organization
Contact information
Practice address
1 MERAMEC BLUFFS DR, BALLWIN, MO 63021-3309
(636) 861-0600
Mailing address
9015 EAGER RD APT 119, SAINT LOUIS, MO 63144-1109
(314) 478-3669
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
01/02/2026
Last updated
01/02/2026
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