Individual
DR. JASON MICHAEL BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4200A TECHNOLOGY CT, CHANTILLY, VA 20151-1214
(571) 528-9796
Mailing address
4200A TECHNOLOGY CT, CHANTILLY, VA 20151-1214
(571) 528-9796
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557050
VA
Other
Enumeration date
06/21/2012
Last updated
06/12/2014
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