Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 426 | NE |
Y | 213ES0000X | Sports Medicine | 426 | NE |
NPI | 1184127375 |
---|---|
Provider Name | Julia Ann Tuttle |
First Address | Lincoln, NE 68588 |
Second Address | Lincoln, NE 68588 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2018 |
Last Update Date | 14/03/2018 |