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Organization

TAMMY T. TULLY OD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY T TULLY OD (PRESIDENT)
(843) 520-0576
Entity
Organization

Contact information

Practice address
1310 N FRASER ST, GEORGETOWN, SC 29440-2800
(843) 520-0576
(843) 520-4398
Mailing address
PO BOX 50997, MYRTLE BEACH, SC 29579-0017
(843) 520-0576
(843) 520-4398

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1061
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DA9681
SC
Enumeration date
06/20/2006
Last updated
08/22/2020
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