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General NPI Number Information
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NPI Number | 1730385014
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Entity Type | Organization
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Legal Business Name | D PATRICK BROCK PSC
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 1015 MASTER ST
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City | CORBIN
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State | KY
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Zip | 40701-1065
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Country | US
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Telephone | 606-528-8659
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Fax | 606-528-8639
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Provider Business Mailing Address
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Address Line | 1015 MASTER ST
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City | CORBIN
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State | KY
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Zip | 40701-1065
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Country | US
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Telephone | 606-528-8659
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Fax | 606-528-8639
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD PATRICK BROCK
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Credential | D.C.
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Telephone | 606-528-8659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4316
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License Number State | KY
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