Individual
MR. SHAWN B SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1 VILLAGE DR STE 200, ABILENE, TX 79606-8232
(325) 691-5519
Mailing address
1 VILLAGE DR STE 200, ABILENE, TX 79606-8232
(325) 691-5519
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2039113
TX
Other
Enumeration date
12/18/2009
Last updated
12/18/2009
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