NPI 1063862464

Gary Sullivan

Practitioner Other Technician Festus, MO

Practice location

Address: 110 N Mill St, Festus, MO 63028-1816
Phone: (636) 931-2700
Fax: (636) 931-1961
Mailing address: 227 Main St, Festus, MO 63028-1952

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Missouri →

Registry record

NPI: 1063862464
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jun 2016
Record last updated: 16 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.