Individual
TRISHA MAE BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, PTA
Contact information
Practice address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819
(802) 748-8141
Mailing address
128 WOODLAND DR, BARRE, VT 05641-3317
(802) 274-2421
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1054
NH
363AS0400X
Surgical Physician Assistant
Primary
055.0031399
VT
Other
Enumeration date
07/11/2014
Last updated
11/09/2018
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