Individual
JESSICA SULLENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 WEST REDSTONE CENTER DR, SUITE 200, PARK CITY, UT 84098
(435) 776-7235
Mailing address
PO BOX 63, 418 GALLIMORE RD, PORT WILLIAM, OH 45164-0063
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2056595
TX
225200000X
Physical Therapy Assistant
PTA 05746
OH
225200000X
Physical Therapy Assistant
PTA 20373
FL
Other
Enumeration date
05/16/2007
Last updated
09/11/2025
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