Individual
AN TULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12 ELM ST, POTSDAM, NY 13676-2166
(315) 261-5420
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(714) 463-0413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026666
NY
Other
Enumeration date
07/11/2021
Last updated
01/03/2022
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