Provider Demographics
NPI:1982478905
Name:BRINK, JAMES WARREN CARROLL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WARREN CARROLL
Last Name:BRINK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 E 2ND ST APT 8
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1783
Mailing Address - Country:US
Mailing Address - Phone:216-215-2750
Mailing Address - Fax:
Practice Address - Street 1:9596 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-2004
Practice Address - Country:US
Practice Address - Phone:513-909-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0207972251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic