Individual
MICHELLE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 EASTMAN RD, CENTER CONWAY, NH 03813-4221
(603) 356-5471
Mailing address
25 HARRIS ST APT 6, ACTON, MA 01720-4111
(978) 856-5090
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH233288
MA
183500000X
Pharmacist
Primary
R2412
NH
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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