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Organization
LIFE ENHANCEMENT MEDICINE AND REHABILITATION, P.A.
Active
Organization
LIFE ENHANCEMENT MEDICINE AND REHABILITATION, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BULLOCK D.O. (PRESIDENT)
(785) 856-5440
Entity
Organization
Contact information
Practice address
3001 CARRINGTON LN, LAWRENCE, KS 66049-1732
(785) 856-5440
(785) 856-5441
Mailing address
3001 CARRINGTON LN, LAWRENCE, KS 66049-1732
(785) 856-5440
(785) 856-5441
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
0531368
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0531368
KS
208VP0000X
Pain Medicine Physician
0531368
KS
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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