Individual
JACLYN KAYE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
800 LAKEFRONT WAY, TWO RIVERS, WI 54241-3301
(920) 320-2436
Mailing address
800 LAKEFRONT WAY, TWO RIVERS, WI 54241-3301
(920) 320-2436
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12600
WI
Other
Enumeration date
07/17/2007
Last updated
12/20/2023
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