Individual
JOSEPH BRYAN BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
914 NORMAN ST, CONWAY, SC 29526-5166
(843) 477-0177
(843) 488-1289
Mailing address
914 NORMAN ST, CONWAY, SC 29526-5166
(843) 477-0177
(843) 488-1289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4807
SC
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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