Individual
MATTHEW WADE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2318 MARKET PLACE DR, MARYVILLE, TN 37801-8704
(865) 984-3141
(865) 984-3893
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
TN
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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