Individual
KIMBERLY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
914 INDUSTRIAL PARK RD, DANDRIDGE, TN 37725-4700
(865) 397-3333
Mailing address
204 GARDNER LN, POWELL, TN 37849-3415
(865) 803-1336
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4911
TN
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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