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Contact Information

MARK N SULLIVAN, PT
400 WATER AVE
ST JOSEPHS REHAB DEPARTMENT
HILLSBORO, WI54634
 Phone: 608-489-8260
 Fax: 608-489-8193
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MARK N SULLIVAN · (Male)

NPI # 1679653455
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 10/16/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 5549024
  • WI Medicaid 40475300
  • WI Other 5415000450861 DPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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