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1093121022
BRENT BULLARD
PASADENA, CA
NPI
1093121022
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2014-07-10
Last Update Date
2014-07-11
Business Address
-- BRENT BULLARD
940 AVENUE 64
PASADENA, CA 91105-2711
Phone number: 323-254-2274
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Mailing Address
-- BRENT BULLARD
940 AVENUE 64
PASADENA, CA 91105-2711
Phone number: 323-254-2274
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