Jenelle M Sullivan, PT

NPI #1376601625 in Jackson, Wyoming

Provider Information

NPI Number: 1376601625
Entity Type: Individual
Name: Jenelle M Sullivan, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Dec 5, 2006
Last Updated: Oct 7, 2010

Practice Location

Address: 1116 MAPLE WAY
City: Jackson
State: Wyoming
ZIP Code: 83002
Phone: (307) 733-7037

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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