Individual
ERNEST BULLOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
800 W BROADWAY ST, WEST MEMPHIS, AR 72301-2912
(870) 735-5174
Mailing address
800 W BROADWAY ST, WEST MEMPHIS, AR 72301-2912
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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