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NPI Code Detail

MEDICARE: KAYLEE BROOKE BROCKMAN PT, DPT

MEDICARE:   KAYLEE BROOKE BROCKMAN  PT, DPT
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 Therapist1404101TX

General Provider Information

NPI Number : 1306651096
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEE BROOKE BROCKMAN PT, DPT
Provider Business Mailing Address
First Line : 3838 50TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79413-3808
Country : US
Telephone Number : 806-792-5522
Fax Number : 806-785-7582
Provider Business Practice Location Address
First Line : 3838 50TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79413-3808
Country : US
Telephone Number : 806-792-5522
Fax Number : 806-785-7582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2025
Last Update Date : 02/27/2025

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Directions to “ KAYLEE BROOKE BROCKMAN PT, DPT” Practice Location

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