Individual
MRS. LISA JEAN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14727 BADEN RD, GERMANTOWN, OH 45327-9407
(937) 604-1811
Mailing address
14727 BADEN RD, GERMANTOWN, OH 45327-9407
(937) 604-1811
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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