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NPI Code Detail

MEDICARE: BOBBIE BROOKER

MEDICARE: BOBBIE BROOKER
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
1225100000XPhysical Therapist9795NC

General Provider Information

NPI Number : 1174508402
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBIE BROOKER
Provider Business Mailing Address
First Line : 508 FULTON ST
Second Line :
City : DURHAM
State : NC
Zip : 27705-3875
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 508 FULTON ST
Second Line :
City : DURHAM
State : NC
Zip : 27705-3875
Country : US
Telephone Number : 919-286-0411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 11/13/2009

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Directions to “ BOBBIE BROOKER ” Practice Location

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