Individual
MISS STEPHANIE MARIE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
277 COVINGTON DR, HIRAM, GA 30141-2257
(757) 287-8914
(844) 550-4221
Mailing address
277 COVINGTON DR, HIRAM, GA 30141-2257
(757) 287-8914
(844) 550-4221
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
12/18/2025
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