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General NPI Number Information
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NPI Number | 1194419697
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Entity Type | Individual
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Provider Name | JULIA CRISTINE BROOKS LMT
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Gender | Female
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 1100 N COLLEGE AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1944
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Country | US
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Telephone | 479-443-4301
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Fax |
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Provider Business Mailing Address
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Address Line | 1298 ELECTRIC AVE APT I202
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City | SPRINGDALE
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State | AR
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Zip | 72764-7615
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Country | US
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Telephone | 910-262-8451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 8596
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License Number State | AR
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