Disa T. Brock
Disa T. Brock is a Psychiatry Physician in Provo, Utah. Practices as a sole proprietor. Licensed in Utah.
- Licensed in
- UT
- In the registry since
- 2020
Practice location Address checks out
2520 N University Ave # 250AProvo, UT 84604-3804
Phone: (801) 337-8277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatry Physician (primary) | Taxonomy 2084P0800X · Licence 9093412-4408 (UT) |
|---|
Record details
| NPI number | 1154961746 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | January 10, 2020 |
| Last updated in NPPES | January 10, 2020 |
| Certification date | January 10, 2020 |
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