Individual
ASHLEY M. BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1229 E SEMINOLE ST, SUITE 520, SPRINGFIELD, MO 65804-2227
(417) 820-5750
(417) 820-5066
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2015006219
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
02/26/2015
Last updated
08/07/2015
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