Individual
ALISSA BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
50 N MEDICAL DR, 1R73 SOM, SALT LAKE CITY, UT 84132-0001
(801) 213-7311
Mailing address
50 N MEDICAL DR, 1R73 SOM, SALT LAKE CITY, UT 84132-0001
(801) 213-7311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9428385-4201
UT
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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