Individual
GARRETT SHANNON BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3701 LOOP RD, TUSCALOOSA, AL 35404-5015
(205) 554-2000
Mailing address
3701 LOOP RD, TUSCALOOSA, AL 35404-5099
(205) 554-2000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4719
AL
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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