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Individual

KATIE M LULLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
150 W MAIN ST, NEW ALBANY, OH 43054-9229
(614) 685-9425
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT019267
OH
2251P0200X
Pediatric Physical Therapist
Primary
PT019267
OH
261QP2000X
Physical Therapy Clinic/Center
070023306
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0484370
OH
Enumeration date
09/07/2017
Last updated
04/10/2025
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