Individual
DR. SAMANTHA JEAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5627 NW 86TH ST STE 200, JOHNSTON, IA 50131-1738
(515) 270-0303
(515) 270-0160
Mailing address
5627 NW 86TH ST STE 200, JOHNSTON, IA 50131-1738
(515) 270-0303
(515) 270-0160
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
096840
IA
Other
Enumeration date
07/16/2019
Last updated
04/06/2023
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