| NPI | 1588892863 |
|---|---|
| Former Name | LORI JO SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ LPT-30750) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501010318) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2019-09-12 |