Individual
LORI P BROCKBANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 442-8400
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 442-8400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
206020-3102
UT
Other
Enumeration date
03/27/2013
Last updated
03/27/2013
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