Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0101260896 | VA |
NPI | 1033553367 |
---|---|
Provider Name | Dr. Brittany Brooks |
First Address | Fort Stewart, GA 31314-5641 |
Second Address | Fort Stewart, GA 31314-5641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2013 |
Last Update Date | 24/10/2021 |