Individual
MR. GARDNER PRITCHARD BROOKSBANK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SPE HEALTH SERVICE P
Contact information
Practice address
4646 POPLAR AVENUE, SUITE 434, MEMPHIS, TN 38117
(901) 767-0956
(901) 767-1956
Mailing address
251 BREMINGTON PLACE, MEMPHIS, TN 38111
(901) 458-0503
(901) 767-1956
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0000000016
TN
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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