Individual
DANIEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2810 PRESTIGE CT APT 3, EAU CLAIRE, WI 54703-6424
(192) 541-3222
Mailing address
2810 PRESTIGE CT APT 3, EAU CLAIRE, WI 54703-6424
(192) 541-3222
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000025709
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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