Provider Demographics
NPI:1942209358
Name:RULLI, NICHOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:RULLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7503 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1856
Mailing Address - Country:US
Mailing Address - Phone:804-261-6685
Mailing Address - Fax:804-515-7771
Practice Address - Street 1:7503 BROOK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1856
Practice Address - Country:US
Practice Address - Phone:804-261-6685
Practice Address - Fax:804-515-7771
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000517Medicare ID - Type Unspecified
VAU47134Medicare UPIN