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General NPI Number Information
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NPI Number | 1942952999
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Entity Type | Organization
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Legal Business Name | KARA BROCK DPM LLC
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 1625 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85719-4330
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Country | US
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Telephone | 520-694-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 8450 S PUEBLO DR
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City | SAFFORD
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State | AZ
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Zip | 85546-7728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARA BROCK
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Credential | DPM
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Telephone | 330-620-0730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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