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NPI Code Detail

MEDICARE: DR. KIMBERLY A SEBOK-STROCK OD

MEDICARE: DR. KIMBERLY A SEBOK-STROCK OD
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
1152W00000XOptometristL703477MI

General Provider Information

NPI Number : 1750300059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY A SEBOK-STROCK OD
Provider Business Mailing Address
First Line : 4281 24TH AVE STE 200
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3997
Country : US
Telephone Number : 810-385-4000
Fax Number : 810-958-7379
Provider Business Practice Location Address
First Line : 735 JOHN R RD STE 150
Second Line :
City : TROY
State : MI
Zip : 48083-5859
Country : US
Telephone Number : 248-577-3659
Fax Number : 248-588-9917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 10/27/2020

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Directions to “ DR. KIMBERLY A SEBOK-STROCK OD” Practice Location

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