Individual
CARLA J BULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
638 N FERDON BLVD STE 1, CRESTVIEW, FL 32536-2170
(850) 331-3017
(855) 975-2575
Mailing address
294 N MAIN ST, CRESTVIEW, FL 32536-3510
(850) 331-3017
(855) 975-2575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23814
FL
2255A2300X
Athletic Trainer
AL2183
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103517900
—
FL
Enumeration date
01/10/2008
Last updated
01/06/2024
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