Bodily, Brock
Bodily, Brock is an individual health care provider with primary practice located at 10623 S Redwood Rd # 101 , South Jordan UT 84095-2481. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Bodily, Brock can be contacted via phone (801) 566-4242.Contact Information
Primary practice address
10623 S Redwood Rd # 101
South Jordan UT 84095-2481
Phone: (801) 566-4242
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 11353289-8002 | Utah |
Profile Details
| NPI number | 1366004517 |
|---|---|
| LBN Legal business name | Bodily, Brock |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2019 |
| Last updated | Jul 8th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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