LAVERNE A SULLIVAN

FORT WAYNE, IN
NPI1023045200
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: IN  37000748A)
Enumeration Date2006-06-26
Last Update Date2014-07-01
Business Address
-- LAVERNE A SULLIVAN RD
4210 FLAGSTAFF CV
FORT WAYNE, IN 46815-4417
Phone number: 260-489-9009
Mailing Address
-- LAVERNE A SULLIVAN RD
5244 JEFFRIES LANE
NEWBURGH, IN 47630
Phone number: 812-454-1710
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