Individual
EDWIN BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2155 LAURELWOOD DR, COLUMBUS, OH 43229-2812
(614) 895-1172
Mailing address
2155 LAURELWOOD DR, COLUMBUS, OH 43229-2812
(614) 895-1172
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
DZK 7575
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155889
—
OH
Enumeration date
02/08/2017
Last updated
02/08/2017
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