Individual
LARRY W. BULLOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 562-3571
Mailing address
1105 CHAMBERLAIN HILL RD, LOUISVILLE, KY 40207-2207
(502) 897-1650
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6871
KY
Other
Enumeration date
02/01/2006
Last updated
07/08/2007
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