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Individual

BROOKE A SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
827 CYPRESS VILLAGE BLVD, SUN CITY CENTER, FL 33573-6838
(813) 633-0669
(813) 633-0881
Mailing address
12631 LAKE VISTA DR, GIBSONTON, FL 33534-3931
(813) 363-1148

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27737
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA27737
FL PTA LICENSE
FL
Enumeration date
04/28/2021
Last updated
04/28/2021
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