Provider Demographics
NPI:1265850747
Name:TULE, DAWN (LCMT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:TULE
Suffix:
Gender:F
Credentials:LCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N BALTIMORE AVE
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:MOUNT HOLLY SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17065-1614
Mailing Address - Country:US
Mailing Address - Phone:717-486-7823
Mailing Address - Fax:
Practice Address - Street 1:408 N BALTIMORE AVE
Practice Address - Street 2:SUITE 202B
Practice Address - City:MOUNT HOLLY SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17065-1614
Practice Address - Country:US
Practice Address - Phone:717-486-7823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG001228172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist