Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1608 | SD |
NPI | 1124494158 |
---|---|
Provider Name | Mrs. Brooke Marie Foley |
First Address | Rapid City, SD 57701-7317 |
Second Address | Rapid City, SD 57701-7317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2015 |
Last Update Date | 13/08/2015 |