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General NPI Number Information
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NPI Number | 1669630117
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Entity Type | Individual
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Provider Name | SARA TULLIUS MPT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 7400 W RAWSON AVE
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City | FRANKLIN
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State | WI
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Zip | 53132-8278
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Country | US
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Telephone | 414-427-6202
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Fax | 414-427-6277
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Provider Business Mailing Address
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Address Line | 8731 S WOOD CREEK DR APT 7
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City | OAK CREEK
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State | WI
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Zip | 53154-7509
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Country | US
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Telephone |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | WI
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