Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DAVID ROLLAND SULLIVAN, L.AC.
Active Sole ProprietorDAVID ROLLAND SULLIVAN, L.AC. is a Athletic Trainer healthcare provider located in MARINE ON ST CROIX, Minnesota. NPI 1396795365 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · MARINE ON ST CROIX, MN
Registration Details
- NPI Number
- 1396795365
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 11, 2006 (20.288966114188 yrs)
- Last Updated
- Jul 19, 2019
- License
-
1288 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
17777 ST CROIX TRAIL NORTHMARINE ON ST CROIX, MN, 55047Browse MN providers · Browse ZIP 55047
- Phone
- 6514335458
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Athletic Trainer
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.