Individual
RYAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3131 TOM AUSTIN HWY, SPRINGFIELD, TN 37172-4801
(615) 382-7979
Mailing address
201 CROSBY DR, DICKSON, TN 37055-1016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2472
TN
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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