Individual
RAIKESHA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18700 US HIGHWAY 90, ROBERTSDALE, AL 36567-3271
(251) 947-1911
Mailing address
9930 WHIP POOR WILL DR, SEMMES, AL 36575-7026
(251) 623-9320
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6790
AL
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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