Basic Information
| Provider Information | |||||||||
| NPI: | 1427252998 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROOKS | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | LYN | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 GILLAND CT | ||||||||
| Address2: | |||||||||
| City: | NOTTINGHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212362901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104215160 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1406B CRAIN HWY S | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210614099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105902334 | ||||||||
| FaxNumber: | 4105902336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 02/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 20044 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.