Provider Demographics
NPI:1386395184
Name:METZLER, BROOKE (PT, DPT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:METZLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E FOX FARM RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82007-2668
Mailing Address - Country:US
Mailing Address - Phone:307-635-2900
Mailing Address - Fax:
Practice Address - Street 1:1215 E FOX FARM RD UNIT B
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82007-2668
Practice Address - Country:US
Practice Address - Phone:307-635-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0018109261QP2000X
WYPT-2130261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy