Mark Nicholas Sullivan, PT

NPI #1679653455 in Hillsboro, Wisconsin

Provider Information

NPI Number: 1679653455
Entity Type: Individual
Name: Mark Nicholas Sullivan, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Oct 16, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 400 WATER AVE
Address 2: ST JOSEPHS REHAB DEPARTMENT
City: Hillsboro
State: Wisconsin
ZIP Code: 54634
Phone: (608) 489-8260

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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