CLARENCE MICHAEL SULLIVAN

FORT SAM HOUSTON, TX
NPI1437756574
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date2020-10-01
Last Update Date2020-10-01
Business Address
CLARENCE MICHAEL SULLIVAN IDMT
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234-4504
Phone number: 210-916-3918
Mailing Address
CLARENCE MICHAEL SULLIVAN IDMT
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234-4504
Phone number:
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