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Individual
ZACHARY TULLEY
Active
Individual
ZACHARY TULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT12188
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT12188
STATE LICENSE NUMBER
TN
01
—
PT6865
STATE LICENSE NUMBER
MS
Enumeration date
04/02/2019
Last updated
02/26/2020
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