Individual
MR. WILLIAM JOSEPH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 315-4662
Mailing address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 315-4662
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2614
OR
Other
Enumeration date
09/04/2006
Last updated
07/17/2007
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