Individual
MR. GRANT A BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4029 DEAN MARTIN DR, LAS VEGAS, NV 89103-4138
(702) 848-2256
Mailing address
3014 W CHARLESTON BLVD STE 130, LAS VEGAS, NV 89102-0083
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DO3385
NV
Other
Enumeration date
04/14/2019
Last updated
02/26/2025
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