Individual
MR. RYAN THOMAS SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
140 BAY ST APT 7, SANTA CRUZ, CA 95060-6156
(304) 695-6707
Mailing address
140 BAY ST APT 7, SANTA CRUZ, CA 95060-6156
(304) 695-6707
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
47991
CA
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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