Individual
SCOTT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
439 CHANNEL RD STE 102, LAKE WYLIE, SC 29710-6101
(803) 746-7800
Mailing address
PO BOX 412066, BOSTON, MA 02241-2066
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12553
SC
225100000X
Physical Therapist
20579
NC
2251X0800X
Orthopedic Physical Therapist
PTL.0015126
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20579
PROFESSIONAL LICENSE
NC
Enumeration date
08/29/2017
Last updated
02/07/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us