Provider Demographics
NPI:1609479310
Name:MARKER, BROOK
Entity Type:Individual
Prefix:
First Name:BROOK
Middle Name:
Last Name:MARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 VALLEY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-1568
Mailing Address - Country:US
Mailing Address - Phone:330-205-4359
Mailing Address - Fax:
Practice Address - Street 1:606 VALLEY ST APT 1
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1568
Practice Address - Country:US
Practice Address - Phone:330-415-0982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health