Individual
MR. DAKOTA BENJAMIN BROOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 WHEELING AVE, GLEN DALE, WV 26038-1697
(304) 221-4570
Mailing address
800 WHEELING AVE, GLEN DALE, WV 26038-1697
(304) 845-3211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2562
WV
363A00000X
Physician Assistant
50.007121RX
OH
Other
Enumeration date
11/05/2021
Last updated
10/09/2024
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