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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 5 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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