Provider Demographics
NPI:1336121177
Name:BROGLI, JULIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:C
Last Name:BROGLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 S 250 E
Mailing Address - Street 2:SUITE 290
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-8100
Mailing Address - Country:US
Mailing Address - Phone:801-747-8700
Mailing Address - Fax:801-747-8701
Practice Address - Street 1:5770 S 250 E
Practice Address - Street 2:SUITE 290
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8100
Practice Address - Country:US
Practice Address - Phone:801-747-8700
Practice Address - Fax:801-747-8701
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT186995-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics