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Individual

JILL MARIE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST

Contact information

Practice address
301 S LAFAYETTE ST, SOUTH LYON, MI 48178-1407
(248) 486-1110
(248) 486-3318
Mailing address
59075 TRAVIS RD, NEW HUDSON, MI 48165-9578

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003385
MI

Other

Enumeration date
11/13/2006
Last updated
07/08/2007
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