NPI 1003982711

Todd Michael Sullivan, MPT

Practitioner Physical Therapist Fort Wayne, IN

Practice location

Address: 3978 New Vision Dr, Fort Wayne, IN 46845-1712
Phone: (260) 373-9318
Fax: (260) 373-9301
Mailing address: 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 05008436A (IN)

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Registry record

NPI: 1003982711
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Nov 2006
Record last updated: 17 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.