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Individual

OLIVIA HUNTINGTON BULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
9050 BIG RUN RD, GAMBIER, OH 43022-9626
(614) 202-9685

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA004717
PA
363AM0700X
Medical Physician Assistant
MA060421
PA

Other

Enumeration date
01/16/2019
Last updated
01/16/2019
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