MEDICARE: RUTH BROOKS 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	8798	TN

General Provider Information

NPI Number	:	1255268702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH BROOKS PTA

Provider Business Mailing Address
First Line	:	218 MIXON LN
Second Line	:
City	:	MANCHESTER
State	:	TN
Zip	:	37355-4931
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 MIXON LN
Second Line	:
City	:	MANCHESTER
State	:	TN
Zip	:	37355-4931
Country	:	US
Telephone Number	:	931-434-9283
Fax Number	:

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

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ RUTH BROOKS PTA” Practice Location

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