Individual provider · Type 1 NPI

Brian G. G. Bullock

Massage Therapist · Morton Grove, IL

NPI number 1407406002 Active

Practice location

9000 Waukegan Rd Ste 100
Morton Grove, IL 60053-2128

Call (847) 779-6050 Map

Fax (847) 929-1167

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X227.003818 (IL)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1407406002

Brian G. G. Bullock's National Provider Identifier is 1407406002, issued on Sep 16, 2019. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Morton Grove, IL. The record was last updated on Sep 16, 2019.