Individual
BROOK DAVID ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
972 N 600 E, SPANISH FORK, UT 84660-1306
(385) 265-6060
(385) 203-0392
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5993982-1206
UT
363AS0400X
Surgical Physician Assistant
01
AZ
Other
Enumeration date
09/13/2012
Last updated
08/30/2021
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