Individual
MS. LATASHA G SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 HOGAN DR, GREENVILLE, SC 29605-5909
(864) 209-5208
Mailing address
9 HOGAN DR, GREENVILLE, SC 29605-5909
(864) 209-5208
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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