Individual
KAY S. BULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
703 MARKET ST, CHERAW, SC 29520-1209
(843) 537-3641
(843) 537-3646
Mailing address
PO BOX 1209, CHERAW, SC 29520-1209
(843) 537-3641
(843) 537-3646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
840
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D08409
—
SC
Enumeration date
02/01/2007
Last updated
03/02/2011
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