Provider Demographics
NPI:1194022301
Name:BROOKS, DEVIN J
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:J
Last Name:BROOKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8665 W FLAMINGO RD
Mailing Address - Street 2:STE. 2000
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8621
Mailing Address - Country:US
Mailing Address - Phone:702-735-9755
Mailing Address - Fax:702-367-9089
Practice Address - Street 1:8665 W FLAMINGO RD
Practice Address - Street 2:STE. 2000
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8621
Practice Address - Country:US
Practice Address - Phone:702-735-9755
Practice Address - Fax:702-367-9089
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner