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JEFFREY MICHAEL BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
544 LONE OAK RD, PADUCAH, KY 42003-4538
(270) 443-6543
Mailing address
5001 JEWELL LN, PADUCAH, KY 42001-9293
(270) 534-8650

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-004550
KY

Other

Enumeration date
06/13/2007
Last updated
07/08/2007
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