Provider Demographics
NPI:1316445703
Name:CHANDLER, BROOKE M (DPT)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:M
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:BROOKE
Other - Middle Name:M
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 412307
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1628 LASKIN RD STE 706
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-7504
Practice Address - Country:US
Practice Address - Phone:757-481-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211725225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist