Provider Demographics
NPI:1871766733
Name:BROOKS, CAROLYN (PT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
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 1:10 ROXANNA ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7096
Mailing Address - Country:US
Mailing Address - Phone:508-872-5133
Mailing Address - Fax:508-628-9788
Practice Address - Street 1:10 ROXANNA ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7096
Practice Address - Country:US
Practice Address - Phone:508-872-5133
Practice Address - Fax:508-628-9788
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic