Individual
DIANE KAYE BULLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 W MAIN ST, GREENWOOD, IN 46142-3115
(317) 408-9069
Mailing address
1627 W 75TH PL, INDIANAPOLIS, IN 46260-3205
(317) 252-4821
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002503A
IN
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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