Misty Star Bullock

NPI 1639354335 - Occupational Therapist - 225X00000X

NPI Details
NPI 1639354335
Gender Female
Enumeration Date 01/01/2008
Last Updated 01/01/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
2032 S FRAZIER ST
PHILADELPHIA PA, 19143-5618, US
Phone (267) 736-9099
Fax
Business Location
2032 S FRAZIER ST
PHILADELPHIA PA, 19143-5618, US
Phone (267) 736-9099
Fax
Toxanomy
Taxonomy Code 225X00000X
License State Florida
License Number OT11929
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According to our database, Miss Misty Star Bullock NPI is 1639354335, taxonomy code is 225X00000X and license number is OT11929, license state is located at Florida. Misty Star Bullock physically located at 2032 S Frazier St, Philadelphia PA, 19143-5618. NPI Number Misty Star Bullock has the Individual type.

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1639354335 NPI number is provided on an as is basis without warranty of any kind. 1639354335 is maintained by the National Plan & Provider Enumeration System. The contents of Misty Star Bullock are for informational purposes only.