Brian G G Bullock

NPI #1407406002 in Morton Grove, Illinois

Provider Information

NPI Number: 1407406002
Entity Type: Individual
Name: Brian G G Bullock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Sep 16, 2019
Last Updated: Sep 16, 2019

Practice Location

Address: 9000 WAUKEGAN RD STE 100
City: Morton Grove
State: Illinois
ZIP Code: 60053-2128
Phone: (847) 779-6050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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