Individual
MS. LUCILYN ANN BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
60 NORTH AVE, TALLMADGE, OH 44278-2011
(330) 670-4242
(330) 670-4241
Mailing address
60 NORTH AVE, TALLMADGE, OH 44278-2011
(330) 630-9726
(330) 634-2194
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50-000779
OH
Other
Enumeration date
02/01/2007
Last updated
03/30/2022
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