James Kyle Bullock
Case Manager/Care Coordinator in Provo, UT. Individual provider (NPI-1).
NPI number1760103972
StatusActive
Last updated in NPPESSep 6, 2022
Details
- NPI
- 1760103972
- Entity type
- Individual (NPI-1)
- Name
- James Kyle Bullock
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 6, 2022
- Certification date
- Sep 6, 2022
- Last updated
- Sep 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
750 N Freedom BlvdProvo, UT 84601-1677
Phone 801-373-4760
Mailing address
750 N Freedom BlvdProvo, UT 84601-1677
Phone 801-373-4760
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