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Individual

SEAN DAVID SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA/L

Contact information

Practice address
804 PLEASANT ST, BROCKTON, MA 02301-3055
(508) 583-6000
Mailing address
42 BISCAYNE AVE, WEYMOUTH, MA 02188-3025
(781) 682-9148

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3586
MA

Other

Enumeration date
11/17/2011
Last updated
11/17/2011
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