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Organization

NEW JERSEY ANYWHERE CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRANT BULLOCK DO (OWNER)
(702) 848-2256
Entity
Organization

Contact information

Practice address
44 PRINCETON AVE STE E, BRICK, NJ 08724-3550
(702) 848-2256
(702) 485-6746
Mailing address
4029 DEAN MARTIN DR, LAS VEGAS, NV 89103-4138

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
03/16/2026
Last updated
03/16/2026
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