Individual
MARISOL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2843
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
03/06/2022
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