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General NPI Number Information
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NPI Number | 1134093131
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Entity Type | Individual
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Provider Name | SHERRY LYNN TULLY
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Gender | Female
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 380 CARATOKE HWY STE J
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City | MOYOCK
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State | NC
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Zip | 27958-8623
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Country | US
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Telephone | 252-232-8086
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Fax | 252-232-9136
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Provider Business Mailing Address
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Address Line | 380 CARATOKE HWY STE J
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City | MOYOCK
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State | NC
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Zip | 27958-8623
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Country | US
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Telephone | 252-232-8086
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Fax | 252-232-9136
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 21420
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License Number State | NC
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