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General NPI Number Information
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NPI Number | 1578786323
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Entity Type | Organization
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Legal Business Name | TULLIUS CHIROPRACTIC & PILATES CENTER
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 902 W GRAND AVE
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City | GROVER BEACH
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State | CA
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Zip | 93433-2136
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Country | US
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Telephone | 760-749-7414
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Fax |
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Provider Business Mailing Address
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Address Line | 902 W GRAND AVE
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City | GROVER BEACH
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State | CA
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Zip | 93433-2136
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Country | US
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Telephone | 760-749-7414
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Fax |
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Authorized Official
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Title or Position | BILLING REPRESENTATIVE
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Name | CAREY CLARK
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Credential |
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Telephone | 760-749-7414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC28750
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License Number State | CA
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