Individual
TRENT DUANE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
137 2ND ST, HENDERSON, KY 42420-3135
(270) 860-9785
Mailing address
137 2ND ST, HENDERSON, KY 42420-3135
(270) 860-9785
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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