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MS. LORI BULLOCK RPT

>> Specialist >> Other Service Providers

Registrant NPI Number: 1821178989

Individual Registrant:
MS. LORI  BULLOCK RPT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
106 N CRITTENDEN ST  MARSHFIELD, MO 65706-1408 US
Tel: 417-859-3991  Fax: 417-859-0100

Contact information for business:
1911 S NATIONAL AVE SUITE 302 SPRINGFIELD, MO 65804-2219 US
Tel: 417-881-4164  Fax: 417-881-1727

Registration Information:
NPI: 1821178989
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
MO109731

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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