Individual
SAVANNAH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1927 MEMORIAL BLVD, MURFREESBORO, TN 37129-1545
(615) 904-9111
Mailing address
1307 WESTLAWN BLVD APT 326, MURFREESBORO, TN 37128-1798
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7200
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U3569493404
CIGNA
TN
Enumeration date
02/25/2020
Last updated
02/25/2020
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