Individual
MR. SCOTT PATRIC SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.H.A.,A.T.C, R.K.T.
Contact information
Practice address
205 S MAIN ST, SUITE C, LONGMONT, CO 80501-1716
(303) 684-9525
(303) 774-7899
Mailing address
1520 RED MOUNTAIN DR, LONGMONT, CO 80504-2277
(303) 684-9525
(303) 774-7899
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
609
CO
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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