Provider Demographics
NPI:1821432014
Name:BROOKSHIRE, PAUL CURTIS (PT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CURTIS
Last Name:BROOKSHIRE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-4799
Mailing Address - Country:US
Mailing Address - Phone:706-782-2585
Mailing Address - Fax:706-782-2112
Practice Address - Street 1:250 PRIME HILL DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4249
Practice Address - Country:US
Practice Address - Phone:770-364-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist