Provider Demographics
NPI:1164870606
Name:WHITNEY, BROOKE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:DOWNS
Mailing Address - State:KS
Mailing Address - Zip Code:67437-1404
Mailing Address - Country:US
Mailing Address - Phone:785-454-3321
Mailing Address - Fax:
Practice Address - Street 1:1218 KANSAS ST
Practice Address - Street 2:
Practice Address - City:DOWNS
Practice Address - State:KS
Practice Address - Zip Code:67437-1404
Practice Address - Country:US
Practice Address - Phone:785-454-3321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1104463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist