Provider Demographics
NPI:1083911952
Name:BROOKS, DAVID COLLINS (DPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:COLLINS
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 HILLCREST PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-4207
Mailing Address - Country:US
Mailing Address - Phone:912-655-9549
Mailing Address - Fax:478-275-2733
Practice Address - Street 1:911 HILLCREST PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4207
Practice Address - Country:US
Practice Address - Phone:912-655-9549
Practice Address - Fax:478-275-2733
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist