Individual
BRANDON BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12050 HIGHWAY 92 STE 116, WOODSTOCK, GA 30188-4287
(770) 516-3072
Mailing address
6397 LEE HWY, CHATTANOOGA, TN 37421-2564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014444
GA
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/28/2019
Last updated
01/06/2022
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