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General NPI Number Information
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NPI Number | 1780473405
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Entity Type | Individual
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Provider Name | MRS. AMBER LEA BROCK
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 3375 WESLEY CHAPEL RD
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City | ZANESVILLE
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State | OH
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Zip | 43701-7154
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Country | US
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Telephone | 740-202-2862
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Fax |
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Provider Business Mailing Address
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Address Line | 31 W 12TH ST
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City | DRESDEN
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State | OH
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Zip | 43821-9794
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Country | US
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Telephone | 740-202-2862
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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