Individual
LEAH ANN BULOW
Active
Individual
LEAH ANN BULOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7777
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507154480A
—
GA
05
—
507154480B
—
GA
01
—
985629
BCBS GA
GA
01
—
985630
BCBS GA
GA
01
—
985631
BCBS GA
GA
Enumeration date
05/31/2006
Last updated
07/25/2011
Update your record
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