Individual
SAMUEL ELI BROOKOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
1000 MAPLEWOOD DR, BRIDGEPORT, WV 26330-9115
(304) 848-0200
Mailing address
2991 DOOLIN RUN RD, NEW MARTINSVILLE, WV 26155-7830
(304) 455-5901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2080
WV
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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