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1861947632
LAURA BROOKE-ELLISON LOCKWOOD
SALT LAKE CITY, UT
NPI
1861947632
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: UT 10078763-1206)
Enumeration Date
2016-08-22
Last Update Date
2018-01-12
Business Address
LAURA BROOKE-ELLISON LOCKWOOD PA-C, MPAS
50 N MEDICAL DR
SALT LAKE CITY, UT 84132-0001
Phone number: 801-581-7818
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Mailing Address
LAURA BROOKE-ELLISON LOCKWOOD PA-C, MPAS
8812 S BLUE JAY LN
COTTONWOOD HEIGHTS, UT 84121-6109
Phone number: 801-301-1790
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