Individual
KATHRYN BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 PATRICK LOOP, COTTAGE GROVE, OR 97424
(541) 221-0355
Mailing address
520 PATRICK LOOP, COTTAGE GROVE, OR 97424
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201408069
OR
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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