Individual
JAMES D BULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2950 NE JELLISON RD, BLUE SPRINGS, MO 64014-0900
(816) 507-3260
Mailing address
2950 NE JELLISON RD, BLUE SPRINGS, MO 64014-0900
(816) 507-3260
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
101805
MO
2251P0200X
Pediatric Physical Therapist
Primary
101805
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22381016
BLUE CROSS BLUE SHIELD IN
MO
05
—
486710726
—
MO
Enumeration date
11/15/2006
Last updated
10/25/2024
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