Individual
MRS. LORI ANN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
816 MARTIN STREET, ENDICOTT, NY 13760
(607) 757-2154
(607) 757-2864
Mailing address
263 RIDGEFIELD RD, ENDICOTT, NY 13760-4256
(607) 757-2154
(607) 757-2864
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
349742
NY
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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