Individual
MISS KRISTINA ANN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, ATC, LMT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009004976
MO
2255A2300X
Athletic Trainer
—
—
225700000X
Massage Therapist
2010036452
MO
Other
Enumeration date
03/31/2006
Last updated
02/19/2016
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