Provider Demographics
NPI:1780816363
Name:HERRINGTON, BROOKE A (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:A
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:A
Other - Last Name:ARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4812 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2038
Mailing Address - Country:US
Mailing Address - Phone:918-622-4126
Mailing Address - Fax:918-270-2398
Practice Address - Street 1:200 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7650
Practice Address - Country:US
Practice Address - Phone:918-245-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist