Individual
KELSEY BULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3456
Mailing address
PO BOX 995, ANN ARBOR, MI 48106-0995
(734) 712-3456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009238
MI
Other
Enumeration date
05/31/2019
Last updated
02/14/2020
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