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1104030238
REGINA ANGELA SULLIVAN
NORTHPORT, AL
NPI
1104030238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 3529)
Enumeration Date
2007-05-09
Last Update Date
2007-07-08
Business Address
Mrs. REGINA ANGELA SULLIVAN PTA
5530 WHITE CEDAR LN
NORTHPORT, AL 35473-1160
Phone number: 205-792-3331
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Mailing Address
Mrs. REGINA ANGELA SULLIVAN PTA
5530 WHITE CEDAR LN
NORTHPORT, AL 35473-1160
Phone number: 205-792-3331
Copy
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