Individual
MRS. MARTHA L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4146 S 7TH STREET, TERRE HAUTE, IN 47802
(812) 242-2332
(812) 242-2772
Mailing address
2306 N 7TH STREET, TERRE HAUTE, IN 47804
(812) 234-3267
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001527A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213923
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/31/2006
Last updated
07/08/2007
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