Charles Ray Bullock

NPI #1023169554 in Mcminnville, Oregon

Provider Information

NPI Number: 1023169554
Entity Type: Individual
Name: Charles Ray Bullock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist/Technologist
Enumeration Date: Jan 12, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 2266 NE MCDANIEL LN
City: Mcminnville
State: Oregon
ZIP Code: 97128-3247
Phone: (503) 435-2083

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist	235500000X	Primary

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