Organization
BROCKBANK FOOT & ANKLE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG BROCKBANK DPM (PRESIDENT)
(509) 868-5865
Entity
Organization
Contact information
Practice address
9690 S 1300 E STE 120, SANDY, UT 84094-3798
(801) 501-4335
(801) 501-4338
Mailing address
9690 S 1300 E STE 120, SANDY, UT 84094-3798
(801) 501-4335
(801) 501-4338
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
356685-0501
UT
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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