Most Relevant Information
Provider Data
| NPI Number: | 1003040858 |
| Provider Name: | MICHELLE YVETTE SULLIVAN DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | PT27523 |
Most Important Dates
| Enumeration Date: | 05/08/2009 |
| Last Updated: | 05/08/2009 |
Provider Practice Location
288 ATCHISON ST
PASADENA
CA
911041002
Practice Location Phone/Fax
| Phone: | 6267984050 |
| Fax: | 6267984050 |
Provider Mailing Location
288 ATCHISON ST
PASADENA
CA
911041002
Provider Mailing Phone/Fax
| Phone: | 6267984050 |
| Fax: | 6267984050 |