Individual
KARLEEN BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TRT
Contact information
Practice address
2700 W 5600 S, ROY, UT 84067-1372
(801) 825-9731
Mailing address
2700 W 5600 S, ROY, UT 84067-1372
(801) 825-9731
Taxonomy
Speciality
Code
Description
License number
State
226000000X
Recreational Therapist Assistant
Primary
9328310-4003
UT
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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