Individual
MRS. AVE' MARIA BULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P. T.
Contact information
Practice address
5998 PROVIDENCE RD, SUITE 106, VIRGINIA BEACH, VA 23464-3824
(757) 672-6490
Mailing address
5998 PROVIDENCE RD, SUITE 106, VIRGINIA BEACH, VA 23464-3824
(757) 672-6490
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2305003048
VA
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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