Individual
MRS. CASEY LEE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
9042 PIMPERNEL DR, SAN DIEGO, CA 92129-3601
(619) 723-5944
(858) 484-2280
Mailing address
9042 PIMPERNEL DR, SAN DIEGO, CA 92129-3601
(619) 723-5944
(858) 484-2280
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24799
CA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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