Individual
BROOKE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1726 BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
Mailing address
659 N 700 E APT 2, PROVO, UT 84606-6905
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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