Individual
MS. TY ALLISON BULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED.
Contact information
Practice address
505 W MAIN ST STE 225, LEWISTOWN, MT 59457-5703
(406) 589-4664
(844) 837-1209
Mailing address
505 W MAIN ST STE 225, LEWISTOWN, MT 59457-5703
(065) 894-6644
(844) 837-1209
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7174089
—
MT
Enumeration date
08/03/2012
Last updated
11/15/2020
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