Individual
BRIANNA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
638 OKOMA DR, OMAK, WA 98841-9525
(509) 826-1550
Mailing address
PO BOX 1121, WINTHROP, WA 98862-1121
(509) 741-0163
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160999481
WA
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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