Individual
MR. RYAN ESLEY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
325 JOHN KNOX RD BLDG T STE 1, TALLAHASSEE, FL 32303-4166
(850) 545-3949
Mailing address
2332 VINKARA DR, TALLAHASSEE, FL 32303-3724
(850) 545-3949
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA50406
FL
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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