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Mrs. Diane Jarrels Sullivan, PTA
Other Technician in Kilmarnock,, Virginia
NPI 1225224983

Diane Jarrels Sullivan is a Other Technician based in Kilmarnock, VA. Diane Jarrels Sullivan practices in Kilmarnock,, VA and has the professional credentials of PTA. The NPI Number for Diane Jarrels Sullivan is 1225224983 and holds a License No. 2306000138 (Virginia).

The current practice location address for Diane Jarrels Sullivan is 500 Irvington Road, Kilmarnock,, VA and can be reached out via phone at 804-435-3435 and via fax at 804-435-3682.

Location: 500 Irvington Road, Kilmarnock,, VA, 22482-0128
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225224983
Provider Name
Diane Jarrels Sullivan
Credential
PTA
Provider Entity Type
Individual
Gender
Female
Address
500 Irvington Road, Kilmarnock,, VA, 22482-0128
Phone Number
804-435-3435
Fax Number
804-435-3682
Provider Enumeration Date
09/17/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
194072 01 VA BC PROVIDER ID
C06278 01 VA MEDICARE
20091 01 VA SENTURA
institution
Provider Business Practice Location Address Details
Address
500 Irvington Road
City
Kilmarnock,
State
Virginia
Zip
22482
Phone Number
804-435-3435
Fax Number
804-435-3682
person
Provider Business Mailing Address Details
Address
500 Irvington Road
City
Kilmarnock,
State
Virginia
Zip
22482
Phone Number
804-435-3435
Fax Number
804-435-3682
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Technician, Other
Speciality
-
Taxonomy
247200000X
License No.
2306000138 (Virginia)
Definition
A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.
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