Individual
KEVIN BRENT TULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19525 OLD HIGHWAY 25 N, FULTON, MS 38843-7286
(662) 231-3556
Mailing address
19525 OLD HIGHWAY 25 N, FULTON, MS 38843-7286
(662) 231-3556
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2142558
TX
225200000X
Physical Therapy Assistant
PTA6244
MS
Other
Enumeration date
12/16/2018
Last updated
12/17/2018
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