Individual
KAILYN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6199
Mailing address
314 MCBRIEN RD APT A41, CHATTANOOGA, TN 37411-4825
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0003537
GA
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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