Ms. JACQUELINE DENISE SULLIVAN -- PTA ATRIC
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1235230400- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA ATRIC
- Status
- Active
Contact & Location
- Address
- 15884 MANCHESTER RD, ELLISVILLE, MO, 63011
- Phone
- (636) 391-5400
- Fax
- (636) 394-9674
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: MO #2000161113