Individual
CARRIE ANN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 E CHAMBERS DR, BOONEVILLE, MS 38829-8938
(662) 728-3174
(662) 728-3175
Mailing address
PO BOX 839, CORINTH, MS 38835-0839
(662) 286-9883
(662) 286-9836
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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