Individual
BROC D PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13846482-1204
UT
207Q00000X
Family Medicine Physician
2015026063
MO
2083A0100X
Aerospace Medicine Physician
2015026063
MO
Other
Enumeration date
05/21/2014
Last updated
05/14/2024
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