Doctor Name: | RYAN JAMES SULLIVAN |
NPI Number: | 1689949331 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 5501015850 |
Business Practice Address: | 3536 Meridian Crossings Suite 240 Okemos, MI - 488644584 |
Business Phone Number: | 5173472495 |
Business Fax Number: | 5173473540 |
Mailing Address: | 3536 Meridian Crossings, Suite 240 OKEMOS |
State: | MI |
Postal Code: | 488644584 |
Phone Number: | 5173472495 |
Fax Number: | 5173473540 |
NPI Enumeration Date: | 03/14/2012 |
NPI Last Update Date: | 07/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501015850 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |