Individual
AMBER BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0006
(678) 709-7438
Mailing address
1040 ALEXANDER DR APT 6222, AUGUSTA, GA 30909-0288
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
113754
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
NA
GA
Other
Enumeration date
06/05/2026
Last updated
06/18/2026
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