Individual
NICOLE C BROOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
840 HAMMOND ST, SUITE 2, BANGOR, ME 04401-4339
(207) 433-7778
(866) 220-5031
Mailing address
42 KIMBALL HILL RD, CORNISH, ME 04020-3629
(207) 299-5688
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2380
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432258299
—
ME
Enumeration date
07/04/2006
Last updated
03/05/2014
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