Individual
STEPHEN D BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
441 S REDWOOD RD, SALT LAKE CITY, UT 84104-3539
(801) 294-6907
(801) 294-6917
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(801) 294-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
375742-4405
UT
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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