Most Relevant Information
Provider Data
| NPI Number: | 1003345554 |
| Provider Name: | BRIDGET SULLIVAN ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | LAT-4697 |
Most Important Dates
| Enumeration Date: | 06/08/2017 |
| Last Updated: | 10/11/2024 |
Provider Practice Location
4030 WELLMAN WAY
MILLER CENTER
WINSTON-SALEM
NC
27109
Practice Location Phone/Fax
| Phone: | 3367584188 |
| Fax: |
Provider Mailing Location
126 BROOKSTOWN AVE APT 150
WINSTON SALEM
NC
271015377
Provider Mailing Phone/Fax
| Phone: | 6154913014 |
| Fax: |