Individual
DR. ETHAN M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2306 FAR HILLS AVE, OAKWOOD, OH 45419-1512
(937) 422-2600
Mailing address
2306 FAR HILLS AVE, OAKWOOD, OH 45419-1512
(937) 422-2600
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
019782
OH
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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