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Individual

DANIEL J. SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, CFP

Contact information

Practice address
34 HENNESSEY AVENUE, BRUNSWICK, ME 04011-0000
(207) 725-7578
(207) 725-7549
Mailing address
34 HENNESSEY AVENUE, BRUNSWICK, ME 04011
(207) 725-7578
(207) 725-7549

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225100000X
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039097
ANTHEM/BCBS
ME
05
281020099
ME
Enumeration date
02/15/2007
Last updated
07/30/2013
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