Individual
MADELINE KLAIRE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
300 3RD AVE SE, MAGEE, MS 39111-3665
(601) 849-5070
Mailing address
1408 VICTORIA LN, BRANDON, MS 39042-6089
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251C2600X
Cardiopulmonary Physical Therapist
—
—
2251E1200X
Ergonomics Physical Therapist
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
PT7542
MS
2251H1200X
Hand Physical Therapist
—
—
2251H1300X
Human Factors Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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