NPI 1225224983

Diane Jarrels Sullivan, PTA

Practitioner Other Technician Kilmarnock,, VA

Practice location

Address: 500 Irvington Road, Kilmarnock,, VA 22482
Phone: (804) 435-3435
Fax: (804) 435-3682
Mailing address: PO Box 128, Kilmarnock, VA 22482-0128

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence 2306000138 (VA)

Other Technician, Other providers in Virginia →

Registry record

NPI: 1225224983
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Sep 2007
Record last updated: 19 Nov 2007

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.