Individual
HALEY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
15 MOUNT PELIA RD, 1022 ELAM CENTER, MARTIN, TN 38237-3313
(731) 881-7679
Mailing address
125 4TH AVE, HUNTINGDON, TN 38344-3908
(731) 415-3329
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2169
TN
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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