Individual
BROOKE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
280 E 500 N APT 7B, PROVO, UT 84606-2966
(801) 673-9421
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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