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Individual

ALICIA JEAN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
2138 MENDON RD STE 302, CUMBERLAND, RI 02864-3836
(401) 443-5000
Mailing address
1 KETTLE POINT AVE, EAST PROVIDENCE, RI 02914-5375

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15318
MA
225100000X
Physical Therapist
Primary
PT01599
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
409016
BLUE CROSS BS BLUE CHIP
RI
Enumeration date
03/08/2007
Last updated
10/25/2024
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