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General NPI Number Information
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NPI Number | 1225736788
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Entity Type | Individual
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Provider Name | ALYSON TULLY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 1400 E CHURCH ST
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City | SANTA MARIA
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State | CA
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Zip | 93454-5906
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Country | US
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Telephone | 844-392-2760
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 24TH ST APT 4
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City | SANTA MONICA
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State | CA
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Zip | 90404-3044
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Country | US
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Telephone | 617-688-5321
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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 | 293342
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License Number State | CA
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