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1417193723
CHARLES SULLIVAN
CONWAY, AR
NPI
1417193723
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-12-17
Last Update Date
2009-08-14
Business Address
-- CHARLES SULLIVAN CMP
132 LOWER RIDGE RD
CONWAY, AR 72032-8518
Phone number: 501-548-9905
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Mailing Address
-- CHARLES SULLIVAN CMP
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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