Provider Demographics
NPI:1174755177
Name:CUMMINGS, BROOKE KRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:KRISTINE
Last Name:CUMMINGS
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 1:1028 TROWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5220
Mailing Address - Country:US
Mailing Address - Phone:517-295-0246
Mailing Address - Fax:855-905-4849
Practice Address - Street 1:1028 TROWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5220
Practice Address - Country:US
Practice Address - Phone:517-295-0246
Practice Address - Fax:855-905-4849
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist