Provider Demographics
NPI:1396014304
Name:BULLOCK, JULIE LM (PHLEBOTOMIST)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LM
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 COUNTY ROUTE 24
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:NY
Mailing Address - Zip Code:13684-3134
Mailing Address - Country:US
Mailing Address - Phone:315-562-8483
Mailing Address - Fax:
Practice Address - Street 1:2980 COUNTY ROUTE 24
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:NY
Practice Address - Zip Code:13684-3134
Practice Address - Country:US
Practice Address - Phone:315-562-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy