MEDICARE: BROOKE LOGAN HAGOOD DPT

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	225100000X	Physical Therapist	PT016835	GA

General Provider Information

NPI Number	:	1255111787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE LOGAN HAGOOD DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3489 CHAMBLEE TUCKER RD STE E
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-4421
Country	:	US
Telephone Number	:	770-936-8025
Fax Number	:

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

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	10/18/2023

Similar Medicare Providers

1811850308 — WILT-LINE JEAN BAPTISTE
Practice Location Address:

3489 CHAMBLEE TUCKER RD STE E
ATLANTA, GA
30341-4421

Practice Phone: 770-936-8025
Practice Fax:

1598333221 — CANDACE CYNTHIA PHILLIPS PT, DPT
Practice Location Address:

3489 CHAMBLEE TUCKER RD STE E
ATLANTA, GA
30341-4421

Practice Phone: 770-936-8025
Practice Fax: 770-936-9890

1982703468 — CHARLES RONALD ELIJAH DMD
Practice Location Address:

4421 ATLANTA HWY
MONTGOMERY, AL
36109

Practice Phone: 334-242-2906
Practice Fax: 334-277-7278

1457448359 — LARRY FULTON BROWDER DMD
Practice Location Address:

4421 ATLANTA HWY
MONTGOMERY, AL
36109

Practice Phone: 334-272-2906
Practice Fax: 334-277-7278

1013688340 — DRS. BROWDER & ELIJAH, P.C.
Practice Location Address:

4421 ATLANTA HWY
MONTGOMERY, AL
36109

Practice Phone: 334-272-2906
Practice Fax: 334-277-7278

1104632835 — MIK'KAL DANIELLE TROUPE RN
Practice Location Address:

1520 CLIFTON RD NE
ATLANTA, GA
30322-4421

Practice Phone: 256-321-2014
Practice Fax:

Directions to “ BROOKE LOGAN HAGOOD DPT” 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 © 2007-2025 (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.