Alexander Brooks

Individual provider Active NPI Physical Therapy Assistant · Salem, WI

NPI 1902524366 · NPPES record last updated Aug 19, 2022

Key facts

NPI
1902524366
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
3086-19 (WI)
Practice address
7137 236TH Ave Ste 101
Salem, WI 53168-8975
Phone
(262) 925-5020
NPI assigned
Aug 19, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3086-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3086-19 WI Yes

Addresses

Primary practice location

7137 236TH Ave Ste 101
Salem, WI 53168-8975

Mailing address

2129 W Raleigh CT
Mequon, WI 53092-5416

Other providers in Salem, WI

All providers in Salem, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.