# TRINITY PROCARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRINITY PROCARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487881561
- **Legal business name:** TRINITY PROCARE
- **Authorized official:** DR. JASON COREY BULLARD M.D. (PRESIDENT)
- **Authorized official phone:** (928) 273-7501

## Contact information

- **Practice address:** 6930 N POLARIS PL, TUCSON, AZ 85741-2435
- **Practice address phone:** (928) 273-7501
- **Mailing address:** 2752 S STEWART AVE, SPRINGFIELD, MO 65804-3859
- **Mailing address phone:** (602) 531-1658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 102091 | CA | — |
| 175L00000X | Homeopath | 102091 | CA | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | H-102091 | CA | Yes |
| 251E00000X | Home Health Agency | 102091 | CA | — |

## Other

- **Enumeration date:** 06/16/2009
- **Last updated:** 06/16/2009