Organization
LIFE ENHANCEMENT MEDICINE AND REHABILITATION, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BULLOCK D.O. (PRESIDENT)
(785) 856-5440
Entity
Organization
Contact information
Practice address
3001 CARRINGTON LN, LAWRENCE, KS 66049-1732
(785) 856-5440
(785) 856-5441
Mailing address
3001 CARRINGTON LN, LAWRENCE, KS 66049-1732
(785) 856-5440
(785) 856-5441
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
0531368
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0531368
KS
208VP0000X
Pain Medicine Physician
0531368
KS
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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