Provider Demographics
NPI:1831246529
Name:MAJORS, BROOKE D (LPTA)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:D
Last Name:MAJORS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 SARDIS RD
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36344-6612
Mailing Address - Country:US
Mailing Address - Phone:334-588-2107
Mailing Address - Fax:
Practice Address - Street 1:100 W LAKE PROFESSIONAL PARK
Practice Address - Street 2:SUITE5
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340-1203
Practice Address - Country:US
Practice Address - Phone:334-684-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23497225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL23497OtherPHYSICAL THERAPY ASSISTAN