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1003804352
MANLY JACKSON SULLIVAN
CARROLLTON, AL
NPI
1003804352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: AL 20081)
Enumeration Date
2005-10-11
Last Update Date
2007-07-09
Business Address
Dr. MANLY JACKSON SULLIVAN MEDICAL DOCTOR
241 ROBERT K WILSON DR
CARROLLTON, AL 35447-8010
Phone number: 205-367-2408
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Mailing Address
Dr. MANLY JACKSON SULLIVAN MEDICAL DOCTOR
241 ROBERT K WILSON DR
CARROLLTON, AL 35447-8010
Phone number: 205-367-2408
Copy
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