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General NPI Number Information
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NPI Number | 1366419228
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Entity Type | Individual
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Provider Name | DAVID CHARLES BOCK PT
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NAVAL SUPPORT ACTIVITY
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City | NEW ORLEANS
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State | LA
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Zip | 70142-0001
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Country | US
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Telephone | 504-678-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 SAINT MICHAEL DR
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City | HARVEY
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State | LA
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Zip | 70058-2513
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Country | US
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Telephone | 504-347-9255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 04987
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License Number State | LA
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