Individual
ANTHONY SULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
197 PIEDMONT BLVD STE 205, ROCK HILL, SC 29732-1846
(803) 639-8066
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-7800
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4890
SC
225XP0200X
Pediatric Occupational Therapist
9482
NC
Other
Enumeration date
02/17/2015
Last updated
06/09/2017
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