ASHLEY MICHELLE BULLOCH

SHREVEPORT, LA
NPI1790429140
Former NameASHLEY DEVILLE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: LA  346459)
Enumeration Date2022-04-22
Last Update Date2025-05-13
Business Address
ASHLEY MICHELLE BULLOCH
1541 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0000
Mailing Address
ASHLEY MICHELLE BULLOCH
1541 KINGS HWY ATTN: PAYORCREDENTIALING
SHREVEPORT, LA 71103-4228
Phone number:
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