Individual
KEITH EDWARD SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1001 SNEATH LN, SAN BRUNO, CA 94066-2308
(650) 871-8645
Mailing address
1717 LOS ALTOS DR, SAN MATEO, CA 94402-3602
(650) 200-9600
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
37244
CA
Other
Enumeration date
09/15/2014
Last updated
01/03/2022
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