Individual
KAYCE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1501 HOLIDAY DR, SULPHUR SPRINGS, TX 75482-4707
(903) 335-8727
Mailing address
4200 FM 3211, CADDO MILLS, TX 75135
(430) 228-3815
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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