Individual
MRS. TRACY L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-A
Contact information
Practice address
13 2ND ST SW, LE MARS, IA 51031-2007
(712) 546-4723
Mailing address
125 1ST ST NW, LE MARS, IA 51031-3507
(712) 546-4723
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
00512
IA
231H00000X
Audiologist
7228
MN
237700000X
Hearing Instrument Specialist
00788
IA
Other
Enumeration date
09/24/2006
Last updated
03/30/2011
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