Doctor Name: | MR. HAROLD EARL TULLOCK |
NPI Number: | 1720108905 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MA33743 |
Business Practice Address: | 60 2nd St Ste. 203 Shalimar, FL - 325791769 |
Business Phone Number: | 8506512286 |
Business Fax Number: | 8506512286 |
Mailing Address: | 56 9th Ave, SHALIMAR |
State: | FL |
Postal Code: | 325791344 |
Phone Number: | 8505434355 |
Fax Number: | 8506512286 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA33743 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |