Brackett, Tully Robert

Brackett, Tully Robert is an individual health care provider with primary practice located at 2914 Cold Springs Rd # B , Placerville CA 95667-4220. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Brackett, Tully Robert can be contacted via phone (530) 626-9240.

Contact Information

Primary practice address
2914 Cold Springs Rd # B Placerville CA 95667-4220
Phone: (530) 626-9240
Fax: (530) 626-8992
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 3374 California

Profile Details

NPI number 1730203753
LBN Legal business name Brackett, Tully Robert
Credentials CAS I
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730203753 NPPES
California Other 3374 REGISTER CAS INTERN

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