Provider Demographics
NPI:1144353137
Name:MAIER, BROOKE (PT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:MAIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11044 SAINT JAMES NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WORTON
Mailing Address - State:MD
Mailing Address - Zip Code:21678-1213
Mailing Address - Country:US
Mailing Address - Phone:410-810-2735
Mailing Address - Fax:410-778-6536
Practice Address - Street 1:11044 SAINT JAMES NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:WORTON
Practice Address - State:MD
Practice Address - Zip Code:21678-1213
Practice Address - Country:US
Practice Address - Phone:410-810-2735
Practice Address - Fax:410-778-6536
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist