Individual
MS. EMILIA MARIA BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4444 FOREST PARK AVE, STE 1210, SAINT LOUIS, MO 63108-2212
(314) 286-1940
(314) 286-1473
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1940
(314) 286-1473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2024018931
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480145320
—
MO
Enumeration date
07/22/2024
Last updated
05/01/2025
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