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Individual

CHRISTA H SULLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
517 N JACKSON ST, ATHENS, TN 37303-3621
(423) 745-4910
(423) 745-2230
Mailing address
517 N JACKSON ST, ATHENS, TN 37303-3621
(423) 745-4910
(423) 745-2230

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000001689
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3066158
TN
Enumeration date
06/23/2005
Last updated
07/17/2007
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