Individual
ROBERT PATRICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2410 19TH ST SE, RIO RANCHO, NM 87124-4857
(505) 452-4200
Mailing address
2410 19TH ST SE, RIO RANCHO, NM 87124-4857
(505) 452-4200
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1433
NM
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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