Individual
KRISTA JANE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3419 W 12600 S, RIVERTON, UT 84065-7265
(801) 693-3941
Mailing address
8020 S LINTON DR, WEST JORDAN, UT 84088-7618
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8757921-2401
UT
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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