Individual
LYDIA ELIZABETH BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1031 CARE WAY, FREDERICKSBURG, VA 22401-8425
(540) 371-7600
Mailing address
215 CHAPEL GREEN RD, FREDERICKSBURG, VA 22405-3723
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110011783
VA
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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