Individual
GEORGIA BROOKSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1800 NOVELL PL, PROVO, UT 84606-6171
(801) 375-5125
Mailing address
1800 NOVELL PL, PROVO, UT 84606-6171
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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