Individual
BROOKE C. ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1361F W. WADE HAMPTON BLVD, PMB 207, GREER, SC 29650
(864) 801-8706
(864) 848-7203
Mailing address
204 SANDSTONE DR, TAYLORS, SC 29687-6641
(949) 872-1507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6936
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211630
—
NC
Enumeration date
03/23/2006
Last updated
07/05/2013
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