Individual
BAILEY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
2557 PEMBROKE RD, GASTONIA, NC 28054-4712
(980) 320-8275
(704) 973-7862
Mailing address
2557 PEMBROKE RD, GASTONIA, NC 28054-4712
(980) 320-8275
(704) 973-7862
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15117
NC
225XP0200X
Pediatric Occupational Therapist
15117
NC
Other
Enumeration date
07/06/2022
Last updated
09/19/2022
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