Individual
KEVIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 ROSEWOOD AVE STE 105, CAMARILLO, CA 93010-5914
(805) 389-4781
Mailing address
450 ROSEWOOD AVE STE 105, CAMARILLO, CA 93010-5914
(805) 389-4781
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11051
CA
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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