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General NPI Number Information
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NPI Number | 1013069590
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Entity Type | Individual
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Provider Name | AMY KATHRYN TULLIS PT, MPT
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 97 COMMERCE WAY SUITE 101
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City | DOVER
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State | DE
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Zip | 19904-8228
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Country | US
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Telephone | 302-734-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 16 MEADOW LARK DR
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City | MILFORD
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State | DE
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Zip | 19963-3905
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Country | US
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Telephone | 302-222-0337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J1-0001516
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License Number State | DE
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