Provider Demographics
NPI:1417308156
Name:BROOKS, ROBERT (MED, ATC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 DEER RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832
Mailing Address - Country:US
Mailing Address - Phone:334-703-5778
Mailing Address - Fax:
Practice Address - Street 1:623 DEER RUN ROAD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832
Practice Address - Country:US
Practice Address - Phone:334-703-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer