Individual
MR. KENT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 MAIN ST SE, BONDURANT, IA 50035-1048
(515) 250-9394
Mailing address
PO BOX 235, BONDURANT, IA 50035-0235
(515) 250-9394
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
C127019
IA
171WH0202X
Home Modifications Contractor
Primary
C127019
IA
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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