Individual
BROCK HASKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11620 S STATE ST STE 1403, DRAPER, UT 84020-7124
(385) 302-7369
(385) 247-8023
Mailing address
11620 S STATE ST STE 1403, DRAPER, UT 84020-7124
(385) 302-7369
(385) 247-8023
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11856179-1206
UT
363A00000X
Physician Assistant
57989
CA
Other
Enumeration date
04/02/2020
Last updated
01/23/2023
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