James Sullivan, PTA

NPI #1003299777 in South Lyon, Michigan

Provider Information

NPI Number: 1003299777
Entity Type: Individual
Name: James Sullivan, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jun 30, 2015
Last Updated: Jun 30, 2015

Practice Location

Address: 10821 BOULDERCREST DRIVE
City: South Lyon
State: Michigan
ZIP Code: 48178
Phone: (313) 717-3291

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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