Provider Demographics
NPI:1356547053
Name:BROOKS, A CAROL (PT)
Entity type:Individual
Prefix:MS
First Name:A
Middle Name:CAROL
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 CARRICK CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3309
Mailing Address - Country:US
Mailing Address - Phone:405-341-9711
Mailing Address - Fax:
Practice Address - Street 1:3317 EAST MEMORIAL RD
Practice Address - Street 2:SUITE 104 JONES PHYSICAL THERAPY
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013
Practice Address - Country:US
Practice Address - Phone:405-475-7080
Practice Address - Fax:405-475-5033
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist