Laura Brooke-Ellison Lockwood, PA-C, MPAS
Physician Assistant, Medical in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1861947632
StatusActive
Last updated in NPPESJan 12, 2018
Details
- NPI
- 1861947632
- Entity type
- Individual (NPI-1)
- Name
- Laura Brooke-Ellison Lockwood
- Credential
- PA-C, MPAS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2016
- Last updated
- Jan 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 10078763-1206 | UT | Yes |
Practice location
50 N Medical DrSalt Lake City, UT 84132-0001
Phone 801-581-7818
Mailing address
8812 S Blue Jay LnCottonwood Heights, UT 84121-6109
Phone 801-301-1790
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All 91 Medical Physician Assistant providers in Salt Lake City · All 24,510 providers in Salt Lake City
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