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Individual

VANESSA BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, ATC

Contact information

Practice address
1901 MOONEY STREET, WINSTON-SALEM, NC 27103
(336) 713-6038
Mailing address
1901 MOONEY STREET, WINSTON-SALEM, NC 27103

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
2251S0007X
Sports Physical Therapist
Primary
P17407
2255A2300X
Athletic Trainer

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
GA
Enumeration date
08/24/2015
Last updated
07/18/2018
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