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General NPI Number Information
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NPI Number | 1629804943
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Entity Type | Organization
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Legal Business Name | KATE BROCK NUTRITION
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 100 M ST SE STE 669
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City | WASHINGTON
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State | DC
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Zip | 20003-3519
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Country | US
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Telephone | 832-244-5283
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Fax |
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Provider Business Mailing Address
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Address Line | 150 I ST SE APT 827
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City | WASHINGTON
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State | DC
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Zip | 20003-4993
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Country | US
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Telephone | 832-244-5283
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE BROCK
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Credential |
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Telephone | 832-244-5283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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