Provider Demographics
NPI:1023889532
Name:BROOKS, ANDREW JAMES (PTA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16254 ECHO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43968-9758
Mailing Address - Country:US
Mailing Address - Phone:330-831-6084
Mailing Address - Fax:
Practice Address - Street 1:EAST LIVERPOOL CITY HOSPITAL
Practice Address - Street 2:425 W 5TH ST
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920
Practice Address - Country:US
Practice Address - Phone:330-385-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
007565225200000X
OH007565225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant