RANDY A BULLOCK

OGDEN, UT
NPI1528099231
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: UT  1996264405)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: UT  8900CS)
Enumeration Date2006-07-05
Last Update Date2007-07-08
Business Address
-- RANDY A BULLOCK APRN W PP SUB
237 26TH ST
OGDEN, UT 84401-3105
Phone number: 801-625-3605
Mailing Address
-- RANDY A BULLOCK APRN W PP SUB
237 26TH ST
OGDEN, UT 84401-3105
Phone number: 801-625-3605