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Organization

SULLIVAN PEDIATRIC THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY SULLIVAN (OCCUPATIONAL THERAPIST)
(502) 396-1472
Entity
Organization

Contact information

Practice address
444 W KENWOOD DR, LOUISVILLE, KY 40214-2859
(502) 396-1472
Mailing address
444 W KENWOOD DR, LOUISVILLE, KY 40214-2859
(502) 396-1472

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
132864
KY

Other

Enumeration date
01/08/2018
Last updated
01/08/2018
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