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Individual

SUSAN BOWLES SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDN, LD

Contact information

Practice address
147 VERA RD STE A, LEXINGTON, SC 29072-3756
(803) 575-0468
Mailing address
407 W MAIN ST, LEXINGTON, SC 29072-2661
(803) 996-0312
(803) 957-2496

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1595
SC

Other

Enumeration date
05/10/2018
Last updated
08/07/2023
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