MEDICARE: MR. MATT KEVIN BULLOCH L.P.C. NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2785863-6004	UT
2	101YM0800X	Mental Health Counselor	2785863-6004	UT

General Provider Information

NPI Number	:	1457526337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATT KEVIN BULLOCH L.P.C. NCC

Provider Business Mailing Address
First Line	:	1009 IRONWOOD CIR
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-5125
Country	:	US
Telephone Number	:	435-327-2137
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 W HIGHWAY 56
Second Line	:	#5
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-4118
Country	:	US
Telephone Number	:	435-327-2137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	11/11/2009

Similar Medicare Providers

1699621839 — ADRIAN JAMES
Practice Location Address:

1100 NANCY JEAN CV
CEDAR PARK, TX
78613-4118

Practice Phone: 737-317-0860
Practice Fax:

1457374357 — HEALTHY DRUGS LLC
Practice Location Address:

827 INKSTER RD
GARDEN CITY, MI
48135-4118

Practice Phone: 734-261-4100
Practice Fax: 734-261-0404

1659583920 — COUNTY OF LAKE
Practice Location Address:

4118 GREENLEAF CT
PARK CITY, IL
60085-8509

Practice Phone: 847-377-8170
Practice Fax:

1952566390 — EMILY JANE GRIFFIN FNP-C
Practice Location Address:

4118 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-248-1267
Practice Fax: 888-674-8344

1376878439 — MS. PHYLLIS SUE LAMON BSW, LCSW
Practice Location Address:

4118 N DREXEL BLVD APT B
OKLAHOMA CITY, OK
73112-6289

Practice Phone: 405-996-7600
Practice Fax: 405-601-1884

1134455702 — MRS. ANN RIESSELMAN STRUVE ARNP
Practice Location Address:

4118 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-248-1267
Practice Fax:

Directions to “ MR. MATT KEVIN BULLOCH L.P.C. NCC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.