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BLAYNE BULLARD CM

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1881883023

Individual Registrant:
 BLAYNE  BULLARD CM
Gender: F
Not Sole Proprietor

Location and contact information for practice:
210 MANOR ST  MARION, AR 72364-1936 US
Tel: 870-739-6818  Fax: 870-739-5852

Contact information for business:
210 MANOR ST  MARION, AR 72364-1936 US
Tel: 870-739-6818  Fax: 870-739-1970

Registration Information:
NPI: 1881883023
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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