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Individual

JUSTIN THOMAS BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
14135 BALLANTYNE CORPORATE PL STE 100, CHARLOTTE, NC 28277-3668
(704) 831-4300
Mailing address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
(704) 335-8448

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001002584
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-02584
NC

Other

Enumeration date
10/18/2010
Last updated
09/12/2024
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