Individual
BRUCE L BULLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1960 28TH ST SE, GRAND RAPIDS, MI 49508-7900
(616) 247-6677
(616) 247-1254
Mailing address
105 W EXCHANGE ST, SPRING LAKE, MI 49456-2024
(616) 846-0620
(616) 844-6079
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004093
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4634126
—
MI
05
—
4703359
—
MI
05
—
4930876
—
MI
05
—
4939450
—
MI
05
—
4947087
—
MI
Enumeration date
07/11/2005
Last updated
10/25/2007
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