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Individual

MR. IVAN SULTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
2265 EXCHANGE ST, ASTORIA, OR 97103-3331
(503) 338-4005
(503) 338-7557
Mailing address
748 15TH ST, ASTORIA, OR 97103-3824
(503) 468-2469
(503) 338-7557

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6705
OR

Other

Enumeration date
08/14/2006
Last updated
07/15/2013
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