| Tracy Tullos Southern Therapy Specialists | |
|
701 E Main St Suite 2 Russellville AR 72801-5247 | |
| (479) 576-2799 | |
| Not Available |
| Full Name | Tracy Tullos Southern Therapy Specialists |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 701 E Main St, Russellville, Arkansas |
| Authorized Official Name and Position | Tracy Tullos (OWNER) |
| Authorized Official Contact | 4795762799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Tullos Southern Therapy Specialists Po Box 9178 Russellville AR 72811-9178 Ph: (479) 498-6750 | Tracy Tullos Southern Therapy Specialists 701 E Main St Suite 2 Russellville AR 72801-5247 Ph: (479) 576-2799 |
| NPI Number | 1114394285 |
|---|---|
| Provider Enumeration Date | 08/25/2015 |
| Last Update Date | 10/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114394285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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