Individual
DERRICK THOMAS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
4500 E CHERRY CREEK SOUTH DR STE 710, DENVER, CO 80246-1534
(303) 432-8487
Mailing address
4695 WALDEN CT, DENVER, CO 80249-8707
(502) 514-1343
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0007710
CO
376K00000X
Nurse's Aide
NA.00799646
CO
Other
Enumeration date
11/30/2022
Last updated
11/30/2022
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