Individual
MR. JONATHAN BULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
425 WINN WAY, DECATUR, GA 30030-1732
(404) 849-6784
Mailing address
425 WINN WAY, DECATUR, GA 30030-1732
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006150
GA
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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