Individual
TIMOTHY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 E ELM ST APT 1203, TROY, AL 36081-3498
(205) 790-2452
Mailing address
601 E ELM ST APT 1203, TROY, AL 36081-3498
(205) 790-2452
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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