Individual
LUKE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1248
(704) 304-7000
Mailing address
1725 W LAKEVIEW DR UNIT 43, JOHNSON CITY, TN 37601-4311
(931) 572-7426
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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