| NPI | 1235209115 |
|---|---|
| Doing Business As | BRYAN T SULLIVAN |
| Entity Type | Organization |
| Authorized Contact | BRYAN TIPTON SULLIVAN Owner 601-982-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MS 80089) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-06-19 |