MARY-MARIE AUSTIN SULLIVAN

PROVO, UT
NPI1770872319
Former NameMARY-MARIE AUSTIN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: UT  8380179-1205)
Enumeration Date2011-04-05
Last Update Date2021-09-14
Business Address
MARY-MARIE AUSTIN SULLIVAN MD
1134 N 500 W STE 102
PROVO, UT 84604-5569
Phone number: 801-341-5200
Mailing Address
MARY-MARIE AUSTIN SULLIVAN MD
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-341-5200