Provider Demographics
NPI:1558301499
Name:BROOKS, KAREN MICHELE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MICHELE
Last Name:BROOKS
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 1:221 BALLPARK RD
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-4861
Mailing Address - Country:US
Mailing Address - Phone:270-756-5007
Mailing Address - Fax:270-756-5004
Practice Address - Street 1:221 BALLPARK RD
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-4861
Practice Address - Country:US
Practice Address - Phone:270-756-5007
Practice Address - Fax:270-756-5004
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY003090OtherLICENSE NUMBER
000000520056OtherBCBS
KY7100062120Medicaid
KY00320001Medicare PIN