Individual
CARRIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 COOPER DR, APALACHIN, NY 13732-4135
(607) 743-0212
Mailing address
6 COOPER DR, APALACHIN, NY 13732-4135
(607) 743-0212
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005590-1
NY
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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