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NPI Code Detail

MEDICARE: KAITLYN BROOKS PTA

MEDICARE: KAITLYN 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
1225200000XPhysical Therapy Assistant10202OR

General Provider Information

NPI Number : 1992665244
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN BROOKS PTA
Provider Business Mailing Address
First Line : 1130 COOPER AVE
Second Line :
City : COTTAGE GROVE
State : OR
Zip : 97424-2771
Country : US
Telephone Number : 541-232-6425
Fax Number :
Provider Business Practice Location Address
First Line : 65 W 30TH AVE
Second Line :
City : EUGENE
State : OR
Zip : 97405-3485
Country : US
Telephone Number : 541-342-5901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2025
Last Update Date : 11/17/2025

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Directions to “ KAITLYN BROOKS PTA” Practice Location

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