Provider Demographics
NPI:1336621747
Name:ORVIS, BROOK ELIZABETH (PT, DPT, WCS, PRPC)
Entity type:Individual
Prefix:DR
First Name:BROOK
Middle Name:ELIZABETH
Last Name:ORVIS
Suffix:
Gender:F
Credentials:PT, DPT, WCS, PRPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3622 LYCKAN PKWY STE 6007
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2539
Mailing Address - Country:US
Mailing Address - Phone:919-695-7828
Mailing Address - Fax:
Practice Address - Street 1:3622 LYCKAN PKWY STE 6007
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2539
Practice Address - Country:US
Practice Address - Phone:919-695-7828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist