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1033465950
SHANE BULLOCK
SALT LAKE CITY, UT
NPI
1033465950
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2012-07-29
Last Update Date
2012-07-29
Business Address
-- SHANE BULLOCK
5456 ARCHES DR
SALT LAKE CITY, UT 84129-1704
Phone number: 801-815-2833
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Mailing Address
-- SHANE BULLOCK
5456 ARCHES DR
SALT LAKE CITY, UT 84129-1704
Phone number:
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