Search › Illinois › 235Z00000X
Gwynetta Bullock
NPI 1427576883 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1801 E Shady Oak Dr
Peoria, IL 61614 - Phone
- (309) 686-1948
Registry record
- Primary taxonomy
- 235Z00000X
235Z00000X
- Sex
- Female
- Record last updated
- 2022-07-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois