Provider Demographics
NPI:1003492638
Name:BULLARD, CHELSEA (DC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BULLARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9765 SAN JOSE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-5467
Mailing Address - Country:US
Mailing Address - Phone:904-539-3425
Mailing Address - Fax:904-619-2837
Practice Address - Street 1:9765 SAN JOSE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5467
Practice Address - Country:US
Practice Address - Phone:904-539-3425
Practice Address - Fax:904-619-2837
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor