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Individual

SOPHIA MISHELLE BULLINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
310 W LAKE ST, MOUNT SHASTA, CA 96067-2119
(530) 926-3826
(530) 926-1279
Mailing address
17602 FISHER RD, WEED, CA 96094-9432
(530) 905-0661

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH187401
CA

Other

Enumeration date
08/05/2022
Last updated
08/05/2022
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