Doctor Name: | LORI M SULLIVAN |
NPI Number: | 1013128412 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 2269 |
Business Practice Address: | 534 North 35th Street Suite D Morehead City, NC - 285574309 |
Business Phone Number: | 2527261802 |
Business Fax Number: | 2527261805 |
Mailing Address: | 1800 Widgeon Dr, MOREHEAD CITY |
State: | NC |
Postal Code: | 285574759 |
Phone Number: | 2522401832 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2007 |
NPI Last Update Date: | 06/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2269 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |