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1700023348
MARK MONTOGOMERY SULLIVAN
MURRAY, UT
NPI
1700023348
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 7131889-1206)
Enumeration Date
2009-01-20
Last Update Date
2010-01-25
Business Address
MARK MONTOGOMERY SULLIVAN PAC, MPAS
5121 COTTONWOOD ST SUITE 320
MURRAY, UT 84107-5701
Phone number: 801-507-3380
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Mailing Address
MARK MONTOGOMERY SULLIVAN PAC, MPAS
2609 OAK CREEK DR
SANDY, UT 84093-6522
Phone number: 801-244-2834
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