Individual
PATRICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
WILFORD HALL AMBULATORY SURGICAL CENTER, 1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-9908
(210) 292-5040
Mailing address
WILFORD HALL AMBULATORY SURGICAL CENTER, 1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-9908
(210) 292-5040
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1312118
TX
2251X0800X
Orthopedic Physical Therapist
291704
CA
Other
Enumeration date
08/03/2016
Last updated
11/02/2018
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