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1427576883
GWYNETTA BULLOCK
PEORIA, IL
NPI
1427576883
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
Enumeration Date
2017-09-06
Last Update Date
2022-07-21
Business Address
GWYNETTA BULLOCK
1801 E SHADY OAK DR
PEORIA, IL 61614-7907
Phone number: 309-686-1948
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Mailing Address
GWYNETTA BULLOCK
1801 E SHADY OAK DR
PEORIA, IL 61614-7907
Phone number: 309-686-1948
Copy
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