Doctor Name: | MR. BARNEY LEE BROOKS |
NPI Number: | 1376765511 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 171WH0202X |
Business Practice Address: | 1800 Indiana Ave. Laporte, IN - 463505210 |
Business Phone Number: | 5742864823 |
Business Fax Number: | 2699264045 |
Mailing Address: | 1800 Indiana Ave., LAPORTE |
State: | IN |
Postal Code: | 463506210 |
Phone Number: | 5742864823 |
Fax Number: | 2699264045 |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | 171WH0202X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |