MIYA VENETIA SULLIVAN

SAINT LOUIS, MO
NPI1649488503
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  2000170998)
Enumeration Date2007-05-21
Last Update Date2007-07-08
Business Address
Ms. MIYA VENETIA SULLIVAN MS, ATC
3672 W PINE MALL BLVD ATHLETICS
SAINT LOUIS, MO 63108-3304
Phone number: 314-977-7024
Mailing Address
Ms. MIYA VENETIA SULLIVAN MS, ATC
19 SOMERSET TERRACE CT
SAINT LOUIS, MO 63136-2406
Phone number: 314-521-5084
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