Individual
DR. BROOKE LYNETTE MANOCCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6661 CLYO RD, CENTERVILLE, OH 45459-2702
(937) 425-4000
(937) 425-4002
Mailing address
1 PRESTIGE PL, SUITE 550, MIAMISBURG, OH 45342-3794
(937) 762-1305
(937) 522-7513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34011470
OH
390200000X
Student in an Organized Health Care Education/Training Program
58.004216
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112512
—
OH
Enumeration date
11/22/2011
Last updated
04/15/2025
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