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NPI Code Detail

MEDICARE: DR. MEGAN JANE BULLOCH LAC

MEDICARE: DR. MEGAN JANE BULLOCH LAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistLAC-012319AZ

General Provider Information

NPI Number : 1760298681
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGAN JANE BULLOCH LAC
Provider Business Mailing Address
First Line : 1843 E SAGEBRUSH RD
Second Line :
City : WILLIAMS
State : AZ
Zip : 86046-9342
Country : US
Telephone Number : 775-790-7606
Fax Number :
Provider Business Practice Location Address
First Line : 705 N LEROUX ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3225
Country : US
Telephone Number : 928-316-6187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2024
Last Update Date : 05/21/2026

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Directions to “ DR. MEGAN JANE BULLOCH LAC” Practice Location

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