Doctor Name: | MISS BROOKE NICOLE TILLMAN |
NPI Number: | 1215250949 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 25312 |
Business Practice Address: | 29605 Us 19 N Suite 360 Clearwater, FL - 337611537 |
Business Phone Number: | 7277846088 |
Business Fax Number: | |
Mailing Address: | 4595 Chancellor St Ne, Unit 104 ST PETERSBURG |
State: | FL |
Postal Code: | 337034369 |
Phone Number: | 5043528984 |
Fax Number: | |
NPI Enumeration Date: | 03/09/2010 |
NPI Last Update Date: | 03/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 25312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |