Organization
ADVANCED SPINE & JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACIE LYNN BULLOCK ARNP (ARNP)
(270) 534-4803
Entity
Organization
Contact information
Practice address
2404 NEW HOLT RD, PADUCAH, KY 42001
(270) 534-4803
(270) 534-4024
Mailing address
2404 NEW HOLT RD, PADUCAH, KY 42001
(270) 534-4803
(270) 534-4024
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3142P
KY
Other
Enumeration date
05/11/2009
Last updated
07/21/2010
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