Individual
BRANDON ELLIS TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3850 CANYONS RESORT DRIVE, PARK CITY, UT 84098-6546
(435) 645-4130
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 645-4130
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
5980963-1205
UT
Other
Enumeration date
09/16/2013
Last updated
08/03/2022
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