Provider Demographics
NPI:1568602191
Name:SCHELBLE, BROOK TRAKAS (RPT)
Entity Type:Individual
Prefix:MRS
First Name:BROOK
Middle Name:TRAKAS
Last Name:SCHELBLE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 CARL SHEALY RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8531
Mailing Address - Country:US
Mailing Address - Phone:803-781-1149
Mailing Address - Fax:803-781-1149
Practice Address - Street 1:1049 CARL SHEALY RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8531
Practice Address - Country:US
Practice Address - Phone:803-781-1149
Practice Address - Fax:803-781-1149
Is Sole Proprietor?:No
Enumeration Date:2009-02-22
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist