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1154856987
DAVID SULLIVAN
MEDFORD, OR
NPI
1154856987
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 22561)
Enumeration Date
2017-04-30
Last Update Date
2019-10-29
Business Address
Mr. DAVID SULLIVAN LMT
100 N GRAPE ST APT 303
MEDFORD, OR 97501-3151
Phone number: 718-825-7245
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Mailing Address
Mr. DAVID SULLIVAN LMT
2503 SARATOGA ST
ASHLAND, OR 97520-1892
Phone number: 718-825-7245
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