Healthcare Provider Details

I. General information

NPI: 1851355986
Provider Name (Legal Business Name): DOROTHY V BULLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 GRANT RD
SALISBURY NC
28146-8424
US

IV. Provider business mailing address

315 GRANT RD
SALISBURY NC
28146-8424
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-4443
  • Fax: 704-638-4443
Mailing address:
  • Phone: 704-638-4443
  • Fax: 704-638-4443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberC19732
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: