Individual
ALISON BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
970 CATHEY ROAD, MIRANDA, CA 95553
(707) 499-9539
Mailing address
PO BOX 395, MIRANDA, CA 95553-0395
(707) 499-9539
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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