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Individual
GRANT BROOKS
Active
Individual
GRANT BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
225400000
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7226940411
NSCA-CPT
WI
Enumeration date
11/17/2014
Last updated
11/26/2014
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