Individual
MARK E BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DSC, ECS, OCS
Contact information
Practice address
312 JASON DR STE 5, RICHMOND, KY 40475-2785
(859) 625-0001
Mailing address
312 JASON DR STE 5, RICHMOND, KY 40475-2785
(859) 625-0001
(859) 625-1109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
001746
KY
225100000X
Physical Therapist
PT38134
FL
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
001746
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000060027
BC/BS LPTA
KY
01
—
000000215122
BC/BS SPTA
KY
01
—
000000310944
BC/BS RPTA
KY
01
—
000000333709
BC/BS HPTA
KY
01
—
611208897
HUMANA
KY
05
—
87000006
—
KY
Enumeration date
11/01/2005
Last updated
12/02/2025
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