ANDREW SULLIVAN

POCATELLO, ID
NPI1912892001
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  6071363)
Enumeration Date2025-06-10
Last Update Date2025-06-10
Business Address
ANDREW SULLIVAN DO
465 MEMORIAL DR
POCATELLO, ID 83201-4098
Phone number: 208-232-7862
Mailing Address
ANDREW SULLIVAN DO
500 S 11TH AVE STE 400
POCATELLO, ID 83201-4880
Phone number: 208-232-7862
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