Jerry L. Sullivan JR. ATC

NPI 1306909551 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1306909551
Gender Male
Enumeration Date 12/19/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3631 S. SIXTH STREET
SPRINGFIELD IL, 62703, US
Phone (217) 341-4955
Fax
Business Location
706 E ASH ST
TAYLORVILLE IL, 62568-1657, US
Phone (217) 824-2863
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State
License Number
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According to our database, Mr. Jerry L. Sullivan JR. ATC NPI is 1306909551, taxonomy code is 2255A2300X Jerry L. Sullivan JR. ATC physically located at 3631 S. Sixth Street, Springfield IL, 62703. NPI Number Jerry L. Sullivan JR. ATC has the Individual type.

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1306909551 NPI number is provided on an as is basis without warranty of any kind. 1306909551 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry L. Sullivan JR. ATC are for informational purposes only.