Individual
DR. HEATHER STONE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5 N MEADOWS RD, MEDFIELD, MA 02052-2317
(508) 359-9119
(508) 359-9115
Mailing address
32 TIMBERLINE RD, MILLIS, MA 02054-1149
(781) 367-1841
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
17688
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000150102
MEDICARE PTAN
MA
01
—
497216
TUFTS
MA
Enumeration date
03/23/2007
Last updated
02/19/2009
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