MARK MONTOGOMERY SULLIVAN

MURRAY, UT
NPI1700023348
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: UT  7131889-1206)
Enumeration Date2009-01-20
Last Update Date2010-01-25
Business Address
-- MARK MONTOGOMERY SULLIVAN PAC, MPAS
5121 COTTONWOOD ST SUITE 320
MURRAY, UT 84107-5701
Phone number: 801-507-3380
Mailing Address
-- MARK MONTOGOMERY SULLIVAN PAC, MPAS
2609 OAK CREEK DR
SANDY, UT 84093-6522
Phone number: 801-244-2834
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