Provider Demographics
NPI:1386797397
Name:BROOKS, JOSHUA DANIEL (PT, MPT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DANIEL
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2370
Mailing Address - Country:US
Mailing Address - Phone:603-455-2657
Mailing Address - Fax:
Practice Address - Street 1:171 FAIR ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3323
Practice Address - Country:US
Practice Address - Phone:603-455-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist