Individual
JORDAN TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 N OIL HILL RD, EL DORADO, KS 67042-3352
(316) 452-5660
Mailing address
520 E AUGUSTA AVE, AUGUSTA, KS 67010
(316) 775-5491
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KS
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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