Individual
MR. THOMAS PATRICK SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
560 LEBO BLVD, BREMERTON, WA 98310-2617
(360) 479-1515
Mailing address
14519 KINGSCROSS CIR NW, SILVERDALE, WA 98383-7996
(360) 261-5425
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160732078
WA
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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