Provider Demographics
NPI:1801013008
Name:BROOKS, ROBERT JOSEPH JR (OTRL)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:BROOKS
Suffix:JR
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28705-8075
Mailing Address - Country:US
Mailing Address - Phone:828-688-2377
Mailing Address - Fax:
Practice Address - Street 1:255 SIERRA DR
Practice Address - Street 2:
Practice Address - City:BAKERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28705-8075
Practice Address - Country:US
Practice Address - Phone:828-688-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5179225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist