Individual
MS. SUSAN E BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MPT
Contact information
Practice address
8620 BIGGIN HILL LN, LOUISVILLE, KY 40220-4117
(502) 364-0902
(502) 364-0099
Mailing address
6641 DIXIE HWY, LOUISVILLE, KY 40258-3909
(502) 364-0902
(502) 364-0099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-014295
IL
225100000X
Physical Therapist
22370
MD
2251X0800X
Orthopedic Physical Therapist
Primary
PT005828
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-014295
STATE LICENSE
IL
01
—
22370
MARYLAND LICENSE
MD
01
—
50053159
PASSPORT HEALTH PLAN
KY
05
—
7100355260
—
KY
Enumeration date
08/03/2006
Last updated
12/21/2021
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