Individual
MAKENNA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 LOMALAND DR, SAN DIEGO, CA 92106-2810
(619) 494-9813
Mailing address
3900 LOMALAND DR, SAN DIEGO, CA 92106-2810
(619) 494-9813
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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