Individual
KHALFANI SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
(202) 877-1000
Mailing address
6801 GOODWIN ST, HYATTSVILLE, MD 20784-2521
(202) 689-4212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001450-1
NY
2255A2300X
Athletic Trainer
AL2581
FL
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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