Individual
ALEX BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 W BAGLEY PARK RD, WEST JORDAN, UT 84081-5697
(801) 282-4315
Mailing address
2938 DAYBREAKER DR, PARK CITY, UT 84098-5855
(435) 659-1262
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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