Individual
MR. BLAIR MICHAEL BULLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MMT, NTS
Contact information
Practice address
316 MADISON ST NE, ALBUQUERQUE, NM 87108-1243
(505) 206-9702
Mailing address
6601 KATHRYN AVE SE, ALBUQUERQUE, NM 87108-4933
(505) 206-9702
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
6984
NM
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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