SAMUEL SULLIVAN

SALEM, OR
NPI1730775495
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: OR  202007792LPN)
Enumeration Date2020-12-16
Last Update Date2020-12-16
Business Address
SAMUEL SULLIVAN
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302-1691
Phone number: 971-304-2200
Mailing Address
SAMUEL SULLIVAN
1332 LYDIA AVE N
KEIZER, OR 97303-7550
Phone number: 516-860-7294
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