MEDICARE: BROOKE HENRY PTA

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
1	225200000X	Physical Therapy Assistant	7775A	AZ

General Provider Information

NPI Number	:	1063601862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE HENRY PTA

Provider Business Mailing Address
First Line	:	18440 S PEEPLES VALLEY RD
Second Line	:
City	:	PEEPLES VALLEY
State	:	AZ
Zip	:	86332-8630
Country	:	US
Telephone Number	:	920-362-0121
Fax Number	:

Provider Business Practice Location Address
First Line	:	2919 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-2717
Country	:	US
Telephone Number	:	520-326-2782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	10/17/2007

Similar Medicare Providers

1952679771 — BARTON DIALYSIS LLC
Practice Location Address:

2901 E GRANT RD
TUCSON, AZ
85716-2717

Practice Phone: 520-325-3408
Practice Fax: 520-325-3469

1336187715 — NEURO AQUATIC REHABILITATION CENTER
Practice Location Address:

2919 E GRANT RD
TUCSON, AZ
85716-2717

Practice Phone: 520-326-2782
Practice Fax: 520-326-9552

1922027663 — MRS. SHARON F LITTLE SLP
Practice Location Address:

2919 E GRANT RD
TUCSON, AZ
85716-2717

Practice Phone: 520-326-2782
Practice Fax: 520-326-3552

1568524239 — VALERIE A MAYRSOHN O T
Practice Location Address:

2919 E GRANT RD
TUCSON, AZ
85716-2717

Practice Phone: 520-326-2782
Practice Fax: 520-296-3552

1043403330 — LAURA KOCH OTR
Practice Location Address:

2919 E GRANT RD
TUCSON, AZ
85716-2717

Practice Phone: 520-326-2782
Practice Fax:

1104091743 — TOTAL RENAL CARE INC
Practice Location Address:

2901 E GRANT RD
TUCSON, AZ
85716-2717

Practice Phone: 520-325-3408
Practice Fax: 520-325-3469

Directions to “ BROOKE HENRY PTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.