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1164061016
STEPHEN S BULLOCK
PORTLAND, OR
NPI
1164061016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 25530)
Enumeration Date
2019-12-24
Last Update Date
2019-12-24
Business Address
STEPHEN S BULLOCK LMT
1720 SW 4TH AVE APT 313
PORTLAND, OR 97201-5531
Phone number: 443-562-9635
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Mailing Address
STEPHEN S BULLOCK LMT
1720 SW 4TH AVE APT 313
PORTLAND, OR 97201-5531
Phone number: 443-562-9635
Copy
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