Individual
KEITH JOSEPH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2800 CHICAGO AVE STE 200, MINNEAPOLIS, MN 55407-1353
(612) 872-2700
Mailing address
7581 9TH ST N STE 100, OAKDALE, MN 55128-6635
(651) 748-4338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4415
MN
Other
Enumeration date
03/24/2006
Last updated
09/24/2019
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