Individual
CATHY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2021 E 52ND ST, INDIANAPOLIS, IN 46205-1486
(317) 490-5526
Mailing address
2021 E 52ND ST, INDIANAPOLIS, IN 46205-1486
(317) 490-5526
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
1013863-1
IN
3747P1801X
Personal Care Attendant
Primary
1013863-1
IN
376J00000X
Homemaker
1013863-1
IN
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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