Individual
BYRAN KENDALL BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3250 W BIG BEAVER RD STE 228, TROY, MI 48084-2909
(248) 792-3633
Mailing address
1400 E JARVIS AVE, HAZEL PARK, MI 48030-1944
(704) 512-9316
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501008226
MI
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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