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General NPI Number Information
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NPI Number | 1225706153
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Entity Type | Individual
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Provider Name | BROOKE ROSE IRELAND PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 10940 FAIRFAX BLVD STE D1
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City | FAIRFAX
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State | VA
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Zip | 22030-4301
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Country | US
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Telephone | 571-321-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-1925
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2022009472
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 65060
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14695
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1347568
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-5284
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License Number State | HI
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP043999T
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License Number State | VA
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