Individual
MRS. DENA ISABEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA., ATC
Contact information
Practice address
450 LAUREL ST, DES MOINES, IA 50314-3045
(515) 323-6485
Mailing address
309 N ANKENY BLVD, SUITE 102, ANKENY, IA 50023-1750
(515) 965-5311
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00988
IA
2255A2300X
Athletic Trainer
05070219
NE
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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