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1194440180
BROOKE DAVIS BENINCOSA
HUNTSVILLE, UT
NPI
1194440180
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WG0000X Registered Nurse, General Practice
(Licence: UT 8145482-3102)
Enumeration Date
2022-10-11
Last Update Date
2022-10-11
Business Address
BROOKE DAVIS BENINCOSA
2891 EVERGREEN PARK DR
HUNTSVILLE, UT 84317-9686
Phone number: 801-497-1872
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Mailing Address
BROOKE DAVIS BENINCOSA
2891 EVERGREEN PARK DR
HUNTSVILLE, UT 84317-9686
Phone number: 801-497-1872
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