Provider Demographics
NPI:1255182044
Name:PULLIE, JARRON
Entity type:Individual
Prefix:
First Name:JARRON
Middle Name:
Last Name:PULLIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-4724
Mailing Address - Country:US
Mailing Address - Phone:419-984-7091
Mailing Address - Fax:
Practice Address - Street 1:1709 SPIELBUSCH AVE STE 107
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5372
Practice Address - Country:US
Practice Address - Phone:419-508-6434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator