Individual
MR. MARK ALLEN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, PT, ATC
Contact information
Practice address
133 MOUNTAIN RD, SUITE 2B., SUFFIELD, CT 06078-2084
(860) 254-5982
Mailing address
40 HEARTHSTONE DR, AGAWAM, MA 01001-3238
(413) 789-2168
(860) 254-5982
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003846
CT
2251S0007X
Sports Physical Therapist
003846
CT
2251X0800X
Orthopedic Physical Therapist
003846
CT
2255A2300X
Athletic Trainer
116
MA
Other
Enumeration date
06/29/2006
Last updated
09/11/2025
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