Individual
LEANN NICHOLE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T
Contact information
Practice address
1010 LEAD AVE SE, ALBUQUERQUE, NM 87106-5214
(505) 724-4400
Mailing address
1010 LEAD AVE SE, ALBUQUERQUE, NM 87106-5214
(505) 724-4400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4692
NM
Other
Enumeration date
08/25/2015
Last updated
10/06/2015
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