Provider Demographics
NPI:1992320691
Name:COURNOYER, BROOKE FORTIER (MSPT, DPT)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:FORTIER
Last Name:COURNOYER
Suffix:
Gender:F
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1300
Mailing Address - Country:US
Mailing Address - Phone:603-767-6936
Mailing Address - Fax:
Practice Address - Street 1:60 TAYLOR WAY
Practice Address - Street 2:
Practice Address - City:SANBORNVILLE
Practice Address - State:NH
Practice Address - Zip Code:03872-4350
Practice Address - Country:US
Practice Address - Phone:603-522-8891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist