Provider Demographics
NPI:1578846291
Name:BULKELEY, LAURIE A (DVM)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:A
Last Name:BULKELEY
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3691
Mailing Address - Country:US
Mailing Address - Phone:530-666-3366
Mailing Address - Fax:530-666-5139
Practice Address - Street 1:235 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3691
Practice Address - Country:US
Practice Address - Phone:530-666-3366
Practice Address - Fax:530-666-5139
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10336174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian