Individual
DOMINIQUE TULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9100 MERRILL RD STE 10, JACKSONVILLE, FL 32225-4349
(904) 725-9994
(904) 725-9138
Mailing address
9100 MERRILL RD STE 10, JACKSONVILLE, FL 32225-4349
(904) 725-9994
(904) 725-9138
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT33721
PT LICENSE
FL
Enumeration date
09/10/2018
Last updated
09/10/2018
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