Individual
SUMMER ALYSE BROEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 N 500 W, PROVO, UT 84604-3305
(801) 377-9661
Mailing address
724 S 1700 W, PAYSON, UT 84651-5747
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
14245436-4003
UT
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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