Most Relevant Information
Provider Data
| NPI Number: | 1003554965 |
| Provider Name: | JEANNE SULLIVAN |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT01114 |
Most Important Dates
| Enumeration Date: | 05/21/2022 |
| Last Updated: | 05/21/2022 |
Provider Practice Location
125 QUAKER HILL LN
PORTSMOUTH
RI
028714072
Practice Location Phone/Fax
| Phone: | 8774073422 |
| Fax: | 8774074329 |
Provider Mailing Location
7 CARNEGIE PLZ
CHERRY HILL
NJ
080031000
Provider Mailing Phone/Fax
| Phone: | 8774073422 |
| Fax: | 8774074329 |