Individual
CHARLES A TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFA
Contact information
Practice address
601 E 13TH ST, SUITE G, GROVE, OK 74344-2989
(918) 786-3391
(918) 786-7264
Mailing address
601 E 13TH ST, SUITE G, GROVE, OK 74344-2989
(918) 786-3391
(918) 786-7264
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110121
CERTIFICATION #
—
Enumeration date
08/08/2008
Last updated
08/08/2008
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