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Individual

BROOKE SLATTEN BALESTRIERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
1396B WESTGATE CENTER DR, WINSTON SALEM, NC 27103-2932
(336) 331-3277
(336) 331-3279
Mailing address
1396B WESTGATE CENTER DR, WINSTON SALEM, NC 27103-2932
(336) 331-3277
(336) 331-3279

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15008
NC
225100000X
Physical Therapist
4754
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15008
PT LICENCE
NC
01
4754
OKLAHOMA LICENSE
OK
Enumeration date
10/16/2013
Last updated
09/16/2014
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