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1326468745
ELAINE S BULLOCK
SHREVEPORT, LA
NPI
1326468745
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2014-04-24
Last Update Date
2014-08-05
Business Address
-- ELAINE S BULLOCK
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-7869
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Mailing Address
-- ELAINE S BULLOCK
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-7869
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