Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 226300000X | Kinesiotherapist |
NPI | 1114360484 |
---|---|
Provider Name | Dr. Kelly A Brooks |
First Address | Corpus Christi, TX 78414-5010 |
Second Address | Corpus Christi, TX 78414-5010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 16/04/2013 |