Individual
MR. MICHAEL J. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., P.A.-C
Contact information
Practice address
112 S JONES BLVD, LAS VEGAS, NV 89107-2614
(702) 838-7110
(702) 838-7112
Mailing address
112 S JONES BLVD, LAS VEGAS, NV 89107-2614
(702) 838-7110
(702) 838-7112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA536
NV
Other
Enumeration date
07/28/2005
Last updated
09/30/2010
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