Individual
SUE BROADHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1317 E 750 N, OREM, UT 84097-5480
(801) 932-2580
Mailing address
1317 E 750 N, OREM, UT 84097-5480
(801) 932-2580
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
278833-3101
UT
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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