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NPI Code Detail

MEDICARE: MR. DAVID CHARLES BOCK PT

MEDICARE: MR. DAVID CHARLES BOCK PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist04987LA

General Provider Information

NPI Number : 1366419228
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID CHARLES BOCK PT
Provider Business Mailing Address
First Line : 1224 SAINT MICHAEL DR
Second Line :
City : HARVEY
State : LA
Zip : 70058-2513
Country : US
Telephone Number : 504-347-9255
Fax Number :
Provider Business Practice Location Address
First Line : NAVAL SUPPORT ACTIVITY
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70142-0001
Country : US
Telephone Number : 504-678-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 07/08/2007

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Directions to “ MR. DAVID CHARLES BOCK PT” Practice Location

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