Individual
ASHLEY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7213 S SIWELL RD, BYRAM, MS 39272-9776
(601) 346-9191
(601) 346-3044
Mailing address
7213 S SIWELL RD, BYRAM, MS 39272-9776
(601) 346-9191
(601) 346-3044
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT2886
MS
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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