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General NPI Number Information
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NPI Number | 1568192110
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH REYNOLDS
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Gender | Female
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 604 COMMONS DR STE D-3
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City | OXFORD
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State | PA
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Zip | 19363-1223
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Country | US
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Telephone | 610-932-3619
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Fax |
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Provider Business Mailing Address
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Address Line | 234 MOUNTAIN HILL RD
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City | PERRYVILLE
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State | MD
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Zip | 21903-1410
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Country | US
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Telephone | 443-252-0254
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | TE1006703
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A5675
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License Number State | MD
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