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1760917207
TYLER ASHLEY SULLIVAN
EAST PROVIDENCE, RI
NPI
1760917207
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Former Name
TYLER ASHLEY ROSA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: RI PA00970)
Enumeration Date
2017-04-21
Last Update Date
2021-10-05
Business Address
TYLER ASHLEY SULLIVAN PA-C
1 KETTLE POINT AVE
EAST PROVIDENCE, RI 02914-5375
Phone number: 401-453-9032
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Mailing Address
TYLER ASHLEY SULLIVAN PA-C
PO BOX 1119
PROVIDENCE, RI 02901-1119
Phone number: 401-443-4150
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