Individual
MR. CARSON DEMETRUIS BROOKS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1126 N GRAND AVE, COVINA, CA 91724-1551
(626) 967-1667
Mailing address
6456 YOUNGSTOWN LN, SAN BERNARDINO, CA 92407-2161
(909) 887-4037
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/02/2007
Last updated
09/12/2007
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