Kathy Bullock

NPI #1255626388 in South Ogden, Utah

Provider Information

NPI Number: 1255626388
Entity Type: Individual
Name: Kathy Bullock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Jun 16, 2011
Last Updated: Jun 16, 2011

Practice Location

Address: 5974 FASHION POINT DR
Address 2: STE 100
City: South Ogden
State: Utah
ZIP Code: 84403-4699
Phone: (801) 479-9644

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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