Individual
INDIA MICHELLE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2245 N SYDENHAM ST APT 2, PHILADELPHIA, PA 19132-4430
(215) 839-9061
Mailing address
2245 N SYDENHAM ST, PHILADELPHIA, PA 19132-4430
(215) 839-9061
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
PA
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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