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Individual

MR. ROBERT LEE BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNA

Contact information

Practice address
6018 WELLBORN TRAIL, LITHONIA, GA 30058
(404) 821-6121
Mailing address
6018 WELLBORN TRAIL, LITHONIA, GA 30058
(404) 821-6121

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
CN0030005255
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251TOOOOOX
GA
05
343900000X
GA
05
347C00000X
GA
05
372600000X
GA
05
374U00000X
GA
05
376K00000X
GA
Enumeration date
04/26/2012
Last updated
04/26/2012
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