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Individual
DEREK JAMES TULLY
Active
Individual
DEREK JAMES TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7685428-1701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7685428-1701
UTAH DEPARTMENT OF PROFESSIONAL LICENSING
UT
01
—
7685428-8911
UTAH DEPARTMENT OF PROFESSIONAL LICENSING
UT
Enumeration date
08/12/2020
Last updated
08/12/2020
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