Provider Information for 1225205420
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Dr. CHARLES L TULLIS Jr. LMFT
Sex: Male
NPI: 1225205420
Last Updated: 2024-10-14
Certification Date: 2024-10-14
Certification Date: 2024-10-14
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1225205420 | ||||||||||||||||
| Enumeration Date | 2008-05-15 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 2005 FAITH AVE ABILENE, KS 67410-1588 United States Phone: 678-982-3295 | Fax: | ||||||||||||||||
| Primary Practice Address | 609S S WASHINGTON ST ABILENE, KS 67410-6679 United States Phone: 678-982-3295 | Fax: | ||||||||||||||||
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