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1154666543
CASEY BULLOCK
ASH FLAT, AR
NPI
1154666543
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-12-11
Last Update Date
2012-12-11
Business Address
-- CASEY BULLOCK Recovery Assistant
44 MARTIN LN
ASH FLAT, AR 72513-9749
Phone number: 870-994-2848
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Mailing Address
-- CASEY BULLOCK Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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