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Nicole D Bullock, LBWMT
Massage Therapist in Mequon, Wisconsin
NPI 1023604048

Nicole D Bullock is a Massage Therapist based in Germantown, WI. Nicole D Bullock practices in Mequon, WI and has the professional credentials of LBWMT. The NPI Number for Nicole D Bullock is 1023604048 and holds a License No. 12824-146 (Wisconsin).

The current practice location address for Nicole D Bullock is 10303 N Port Washington Rd Ste 102, Mequon, WI and can be reached out via phone at 262-505-7950. You can also correspond with Nicole D Bullock through the mailing address at W140N11945 COUNTRY AIRE DR, GERMANTOWN, WI - 53022-2700 (mailing address contact number: 262-505-7950).

Location: 10303 N Port Washington Rd Ste 102, Mequon, WI, 53022-2700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023604048
Provider Name
Nicole D Bullock
Credential
LBWMT
Provider Entity Type
Individual
Gender
Female
Address
10303 N Port Washington Rd Ste 102, Mequon, WI, 53022-2700
Phone Number
262-505-7950
Fax Number
Provider Enumeration Date
12/14/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
10303 N Port Washington Rd Ste 102
City
Mequon
State
Wisconsin
Zip
53092-5760
Phone Number
262-505-7950
Fax Number
person
Provider Business Mailing Address Details
Address
10303 N Port Washington Rd Ste 102
City
Mequon
State
Wisconsin
Zip
53092-5760
Phone Number
262-505-7950
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
12824-146 (Wisconsin)
Definition
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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