Individual
MRS. MARIANNE E SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
600 W 12TH ST, IMPERIAL, NE 69033-3130
(308) 882-7111
Mailing address
PO BOX 819, IMPERIAL, NE 69033-0819
(308) 882-7111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
832
NE
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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