Doctor Name: | ROBERT GERARD SULLIVAN |
NPI Number: | 1740504406 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | MT-510 |
Business Practice Address: | 6726 S Revere Pkwy Suite 120 Centennial, CO - 801123961 |
Business Phone Number: | 3037366227 |
Business Fax Number: | 3037366244 |
Mailing Address: | 6726 S Revere Pkwy, Suite 120 CENTENNIAL |
State: | CO |
Postal Code: | 801123961 |
Phone Number: | 3037366227 |
Fax Number: | 3037366244 |
NPI Enumeration Date: | 03/23/2010 |
NPI Last Update Date: | 03/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT-510 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |