Individual
JENNIFER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
6799 KRENSON OAKS CIR, LAKELAND, FL 33810-2157
(727) 804-9102
Mailing address
6799 KRENSON OAKS CIR, LAKELAND, FL 33810-2157
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4073
FL
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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