Provider Demographics
NPI:1982853065
Name:BROOKER, LOREN GAIL (OTR)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:GAIL
Last Name:BROOKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2265
Mailing Address - Country:US
Mailing Address - Phone:836-368-2413
Mailing Address - Fax:610-438-2024
Practice Address - Street 1:5959 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2075
Practice Address - Country:US
Practice Address - Phone:863-385-5454
Practice Address - Fax:863-385-3930
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist