Individual
MRS. BROOKE JOYCE PRILLAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
812 E CHURCH ST, MARTINSVILLE, VA 24112-3109
(276) 638-4890
(276) 638-5139
Mailing address
110 FAIRVIEW DR, BASSETT, VA 24055-6010
(276) 734-0205
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
0119-007432
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119-007432
VIRGINIA BOARD OF MEDICINE STATE LICENSE NUMBER
VA
Enumeration date
08/11/2017
Last updated
08/11/2017
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