Individual
JUSTIN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1420 WALNUT ST STE 1350, PHILADELPHIA, PA 19102-4019
(215) 664-3200
Mailing address
2506 CHATHAM RD, LANSING, MI 48910-2406
(267) 774-7088
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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