LANCE EVERETT BULLOCK

GONZALES, LA
NPI1225236235
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: LA  09761R)
Enumeration Date2007-07-11
Last Update Date2009-05-21
Business Address
-- LANCE EVERETT BULLOCK
3136 S SAINT LANDRY AVE
GONZALES, LA 70737-5801
Phone number: 225-647-7524
Mailing Address
-- LANCE EVERETT BULLOCK
37459 ULTIMA PLAZA BLVD STE B-227
PRAIRIEVILLE, LA 70769-3856
Phone number: 225-673-8258