Individual
NATALIE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
618 MAIN ST, LEWISTON, ME 04240-5935
(207) 795-6110
Mailing address
42 WASHINGTON AVE, PORTLAND, ME 04101-2622
(802) 578-6524
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4484
ME
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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