MEDICARE: MEGAN BROOKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer	2000056968

General Provider Information

NPI Number	:	1851170757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN BROOKS

Provider Business Mailing Address
First Line	:	3423 S BUCKSKIN WAY
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85286-0800
Country	:	US
Telephone Number	:	949-899-2125
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 E 250 S
Second Line	:	HPER WEST, ROOM 113
City	:	SALT LAKE CTY
State	:	UT
Zip	:	84112
Country	:	US
Telephone Number	:	801-585-1820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	05/12/2025

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Directions to “ MEGAN BROOKS ” Practice Location

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