Individual
CHARLETTE LULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
714 W ARAPAHO RD, RICHARDSON, TX 75080-4156
(919) 424-5078
Mailing address
12009 COIT RD APT M2142, DALLAS, TX 75251-2436
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2164720
TX
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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