Individual
CHRISTOPHER GARRETT BOULLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
920 DOUG WHITE DR STE 130, MYRTLE BEACH, SC 29572-4180
(843) 848-1440
(843) 839-1654
Mailing address
920 DOUG WHITE DR STE 130, MYRTLE BEACH, SC 29572-4180
(843) 848-1440
(843) 839-1654
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1429
SC
207X00000X
Orthopaedic Surgery Physician
5101016197
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01429100
—
SC
Enumeration date
04/04/2007
Last updated
01/26/2022
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