Individual provider · Type 1 NPI

Jacqueline Denise Sullivan, PTA ATRIC

Physical Therapy Assistant · Ellisville, MO

NPI number 1235230400 Active

Practice location

15884 Manchester Rd
Ellisville, MO 63011

Call (636) 391-5400 Map

Fax (636) 394-9674

Mailing address

785 Manresa
Florissant, MO 63031-7237

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X2000161113 (MO)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1235230400

Jacqueline Denise Sullivan, PTA ATRIC's National Provider Identifier is 1235230400, issued on Sep 26, 2006. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Ellisville, MO. The record was last updated on Jul 8, 2007.