Individual
DONALD CHAD SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
1650 KENSINGTON PL, SPRINGDALE, AR 72764-1159
(479) 283-0024
(636) 444-8533
Mailing address
1650 KENSINGTON PL, SPRINGDALE, AR 72764-1159
(479) 283-0024
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1114
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132983721
—
AR
Enumeration date
02/19/2007
Last updated
07/24/2019
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