Individual
MR. PATRICK BENJAMIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
724 SANHILL DR, LYNCHBURG, VA 24502-4924
(540) 290-7502
Mailing address
724 SANHILL DR, LYNCHBURG, VA 24502-4924
(540) 290-7502
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2255A2300
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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