Individual
DR. ERICA SUZANNE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4200A TECHNOLOGY CT, CHANTILLY, VA 20151-1214
(571) 528-9797
Mailing address
4200A TECHNOLOGY CT, CHANTILLY, VA 20151-1214
(571) 528-9797
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557049
VA
Other
Enumeration date
06/27/2012
Last updated
06/12/2014
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