Provider Demographics
NPI:1134334238
Name:BROOKS, ERIC DAVID (PT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DAVID
Last Name:BROOKS
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 1:3157 LANDING FALLS LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616
Mailing Address - Country:US
Mailing Address - Phone:919-266-9403
Mailing Address - Fax:
Practice Address - Street 1:301 KILDAIRE WOODS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-481-9199
Practice Address - Fax:919-481-3362
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist