Healthcare Provider Details

I. General information

NPI: 1134088263
Provider Name (Legal Business Name): EMILY TULLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11169 E I25 FRONTAGE RD STE C
FIRESTONE CO
80504-5211
US

IV. Provider business mailing address

11169 E I25 FRONTAGE RD STE C
FIRESTONE CO
80504-5211
US

V. Phone/Fax

Practice location:
  • Phone: 720-600-0370
  • Fax:
Mailing address:
  • Phone: 980-395-2094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021079
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: