Provider Demographics
NPI:1518422419
Name:MARTIN, BROOKE STROUD (DC)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:STROUD
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 ARCHDALE RD
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-2710
Mailing Address - Country:US
Mailing Address - Phone:336-434-2107
Mailing Address - Fax:336-434-2109
Practice Address - Street 1:3204 ARCHDALE RD
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-2710
Practice Address - Country:US
Practice Address - Phone:336-434-2107
Practice Address - Fax:336-434-2109
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor