Individual
JEREL BULLOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1091 W SOUTH JORDAN PKWY, SUITE 500, SOUTH JORDAN, UT 84095-8820
(801) 213-9850
(801) 213-9855
Mailing address
1091 W SOUTH JORDAN PKWY, SUITE 500, SOUTH JORDAN, UT 84095-8820
(801) 213-9850
(801) 213-9855
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
339863-1701
UT
Other
Enumeration date
05/18/2006
Last updated
07/08/2007
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