# ORTHOSPORT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ortho Sport Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477832897
- **Authorized official:** MRS. KERRIE BROOKS DPT,ATC (CO OWNER)
- **Authorized official phone:** (561) 328-9298

## Contact information

- **Practice address:** 8371 N MILITARY TRL, \#106, WEST PALM BEACH, FL 33410-6300
- **Practice address phone:** (561) 328-9298
- **Practice address fax:** (561) 328-9348
- **Mailing address:** 8371 N MILITARY TRL, \#106, WEST PALM BEACH, FL 33410-6300
- **Mailing address phone:** (561) 328-9298
- **Mailing address fax:** (561) 328-9348

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | PT19952 | FL | Yes |

## Other

- **Enumeration date:** 08/16/2011
- **Last updated:** 08/30/2011