Provider Demographics
NPI:1588354153
Name:DAL SANTO, BROOKE (DPT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:DAL SANTO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11809 SILVER CHASE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4646
Mailing Address - Country:US
Mailing Address - Phone:847-845-0125
Mailing Address - Fax:
Practice Address - Street 1:11809 SILVER CHASE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-4646
Practice Address - Country:US
Practice Address - Phone:847-845-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1354169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist