MEDICARE: TIMOTHY TULPPO P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2027	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	11632650	OTHER		CAQH

General Provider Information

NPI Number	:	1861590531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY TULPPO P.T.

Provider Business Mailing Address
First Line	:	555 N ARLINGTON AVE
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-4723
Country	:	US
Telephone Number	:	775-786-3040
Fax Number	:	775-786-1887

Provider Business Practice Location Address
First Line	:	5070 ION DR STE 210
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89436-1612
Country	:	US
Telephone Number	:	775-786-3040
Fax Number	:	775-348-3054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	04/29/2022

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Directions to “ TIMOTHY TULPPO P.T.” Practice Location

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