Individual
ELIZABETH G BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
9 HAYWOOD AVE, RUTLAND, VT 05701-4832
(802) 747-6428
Mailing address
4446 UPPER COLD RIVER RD, SHREWSBURY, VT 05738-9507
(802) 492-2070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0002629
VT
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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