Individual
PATRICK SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 SILVER BLUFF DR, CANTON, NC 28716-6350
(828) 648-2044
Mailing address
23 KIRBY ROAD, ASHEVILLE, NC 28806
(207) 317-7009
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5883
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225200000X
—
NC
Enumeration date
10/06/2016
Last updated
10/06/2016
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