Brock Medical, LLC

NPI #1023379815 in London, Kentucky

Provider Information

NPI Number: 1023379815
Entity Type: Organization
Organization Name: Brock Medical, LLC
Primary Specialty: Nurse Practitioner
Enumeration Date: Jun 7, 2012
Last Updated: Dec 14, 2018

Practice Location

Address: 1752 HIGHWAY 192 W
Address 2: SUITE 1
City: London
State: Kentucky
ZIP Code: 40741-1675
Phone: (606) 330-0055

Authorized Official

Name: ANDREW MICHAEL DEANE
Title: VP FINANCE
Phone: (615) 600-3480

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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