Individual provider · Type 1 NPI
Laura Brooke-Ellison Lockwood, PA-C, MPAS
Medical Physician Assistant · Salt Lake City, UT
NPI number
1861947632
Active
Practice location
50 N Medical Dr
Salt Lake City, UT 84132-0001
Mailing address
8812 S Blue Jay Ln
Cottonwood Heights, UT 84121-6109
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 10078763-1206 (UT) |
Medical Physician Assistant: Definition to come...
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About NPI 1861947632
Laura Brooke-Ellison Lockwood, PA-C, MPAS's National Provider Identifier is 1861947632, issued on Aug 22, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Salt Lake City, UT. The record was last updated on Jan 12, 2018.