Provider Demographics
NPI:1770331654
Name:BROOKS, JOENET G
Entity type:Individual
Prefix:
First Name:JOENET
Middle Name:G
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5838 MONICA LN
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5102
Mailing Address - Country:US
Mailing Address - Phone:216-972-2546
Mailing Address - Fax:
Practice Address - Street 1:5838 MONICA LN
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-5102
Practice Address - Country:US
Practice Address - Phone:216-972-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver