Individual
ANGELICA BULLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7700 MINNESOTA AVE, SAINT LOUIS, MO 63111-3336
(314) 437-5243
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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