Healthcare Provider Details

I. General information

NPI: 1427973213
Provider Name (Legal Business Name): REGINALD TULL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 ONTARIO RD NW
WASHINGTON DC
20009-2144
US

IV. Provider business mailing address

2701 ONTARIO RD NW
WASHINGTON DC
20009-2144
US

V. Phone/Fax

Practice location:
  • Phone: 202-299-9005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT0878
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: