Individual
SHELBY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1300 VETERANS RD, WARRENSBURG, MO 64093-8294
(660) 543-5064
Mailing address
800 S MAIN ST, CLINTON, MO 64735-2624
(660) 525-3028
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2016037538
MO
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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