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Individual

JERI BULLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COSMETOLOGIST

Contact information

Practice address
15800 NORTHCROSS DR STE 103, HUNTERSVILLE, NC 28078-5070
(310) 500-8866
Mailing address
10000 CALDWELL DEPOT RD, CORNELIUS, NC 28031-8128
(310) 500-8866

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary

Other

Enumeration date
11/07/2023
Last updated
11/07/2023
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