Individual
COLTEN BRIAR SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1019 BROAD ST, DURHAM, NC 27705-4143
(919) 797-9588
Mailing address
1019 BROAD ST, DURHAM, NC 27705-4143
(919) 797-9588
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P18599
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P18599
LICENSE NUMBER
NC
Enumeration date
02/25/2019
Last updated
04/18/2022
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