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NPI Code Detail

MEDICARE: JENNIFER BROOKS

MEDICARE:   JENNIFER  BROOKS
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1467754234
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BROOKS
Provider Business Mailing Address
First Line : 7336 RIBBON RIDGE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-4405
Country : US
Telephone Number : 702-686-6782
Fax Number :
Provider Business Practice Location Address
First Line : 7336 RIBBON RIDGE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-4405
Country : US
Telephone Number : 702-686-6782
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2010
Last Update Date : 12/08/2016

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Directions to “ JENNIFER BROOKS ” Practice Location

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