Individual
DAN T SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3780 E POND APPLE DR, SPRINGFIELD, MO 65809-4147
(417) 883-7995
(417) 882-2560
Mailing address
3780 E POND APPLE DR, SPRINGFIELD, MO 65809-4147
(417) 883-7995
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
MDR4804
MO
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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