Individual
KIMBERLY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1200 OAKLEAF WAY STE A, ALTOONA, WI 54720-2245
(715) 832-1400
(715) 832-4187
Mailing address
1200 OAKLEAF WAY STE A, ALTOONA, WI 54720-2245
(715) 832-1400
(715) 832-4187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
466
OK
363A00000X
Physician Assistant
Primary
3971
WI
Other
Enumeration date
01/15/2008
Last updated
02/10/2023
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