Colette Devona Bullock D.O.

NPI 1164612370 - Internal Medicine - 207R00000X

NPI Details
NPI 1164612370
Gender Female
Enumeration Date 07/25/2007
Last Updated 04/10/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
1 MEDICAL CENTER BLVD
POB I, SUITE 404
CHESTER PA, 19013-3902, US
Phone (610) 619-8590
Fax (610) 619-8591
Business Location
1 MEDICAL CENTER BLVD
POB I, SUITE 404
CHESTER PA, 19013-3902, US
Phone
Fax
Toxanomy
Taxonomy Code 207R00000X
License State New Jersey
License Number 25MB08802400
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According to our database, Colette Devona Bullock D.O. NPI is 1164612370, taxonomy code is 207R00000X and license number is 25MB08802400, license state is located at New Jersey. Colette Devona Bullock D.O. physically located at 1 Medical Center Blvd, Chester PA, 19013-3902. NPI Number Colette Devona Bullock D.O. has the Individual type.

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1164612370 NPI number is provided on an as is basis without warranty of any kind. 1164612370 is maintained by the National Plan & Provider Enumeration System. The contents of Colette Devona Bullock D.O. are for informational purposes only.