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1063436848
JOHNNIE RAY BROOKS
JACKSONVILLE, FL
NPI
1063436848
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: FL PA 9103751)
Enumeration Date
2006-07-26
Last Update Date
2007-07-08
Business Address
Mr. JOHNNIE RAY BROOKS pa-c
1503 OAK ST
JACKSONVILLE, FL 32204-3910
Phone number: 904-634-0640
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Mailing Address
Mr. JOHNNIE RAY BROOKS pa-c
7305 PURPLE AVENS AVE
UPPER MARLBORO, MD 20772-6327
Phone number: 301-599-0787
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