Individual
DR. JESSICA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1816 W MAIN ST, DOTHAN, AL 36301-1320
(334) 790-3879
Mailing address
1121 S BRANNON STAND RD, APT B10, DOTHAN, AL 36305-7367
Taxonomy
Speciality
Code
Description
License number
State
111NP0017X
Pediatric Chiropractor
Primary
2398
AL
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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