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Individual

SAM BROOKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
105 EXECUTIVE DR STE C, LAFAYETTE, IN 47905-4869
(219) 472-8900
Mailing address
1801 WATERMARK DR, COLUMBUS, OH 43215-7088

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
02/20/2023
Last updated
02/20/2023
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Product
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