Individual
CAROLE LEE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD/N, CDE
Contact information
Practice address
120 REECE PARK LN, TALLAHASSEE, FL 32301-2829
(850) 212-0383
Mailing address
120 REECE PARK LN, TALLAHASSEE, FL 32301-2829
(850) 212-0383
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND185
FL
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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