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Individual

DIANA W BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
10400 IRON BRIDGE RD, CHESTER, VA 23831-1427
(804) 796-1518
(804) 796-1543
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205128
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043401169
VA
01
192935
BCBS (PHYSICAL THERAPY)
VA
01
7048994
AETNA
VA
01
P00412008
RAILROAD MEDICARE
VA
Enumeration date
08/05/2007
Last updated
04/13/2018
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