Healthcare Provider Details

I. General information

NPI: 1982973087
Provider Name (Legal Business Name): ROB ALAN BROOKES ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FT. CAMPBELL 101ST AIRBORNE DIV 2MBCT
FT. CAMPBELL KY
42222
US

IV. Provider business mailing address

1769 MANNING DR APT C
CLARKSVILLE TN
37042-8824
US

V. Phone/Fax

Practice location:
  • Phone: 315-244-4447
  • Fax:
Mailing address:
  • Phone: 315-244-4447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT984
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT2282
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: