Individual
IVAN TUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 S PACIFIC AVE, LODI, CA 95242-3020
(209) 331-7695
Mailing address
1305 E VINE ST, LODI, CA 95240-3148
(209) 331-7000
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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