Individual
MOLLY BROTHERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1055 N 500 W, SUITE 222, PROVO, UT 84604-3305
(801) 377-4623
(801) 377-6832
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
224062-1206
UT
Other
Enumeration date
07/12/2006
Last updated
11/27/2023
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