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General NPI Number Information
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NPI Number | 1922006436
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Entity Type | Individual
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Provider Name | GEORGE W TULL JR. OD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 2232 N 7TH ST SUITE 10
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7459
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Country | US
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Telephone | 970-242-4909
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Fax | 970-243-7171
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Provider Business Mailing Address
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Address Line | 2232 N 7TH ST SUITE 10
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7459
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Country | US
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Telephone | 970-242-4909
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Fax | 970-243-7171
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | CO1426
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License Number State | CO
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