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Organization
BROCK MEDICAL, LLC
Active
Organization
BROCK MEDICAL, LLC
Active
Other names
First Care Clinics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MICHAEL DEANE (VP FINANCE)
(615) 600-3480
Entity
Organization
Contact information
Practice address
1752 HIGHWAY 192 W, SUITE 1, LONDON, KY 40741-1675
(606) 330-0055
(888) 467-5236
Mailing address
2809 AZALEA PL, NASHVILLE, TN 37204-3117
(888) 467-5236
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005556
KY
Other
Enumeration date
06/07/2012
Last updated
12/14/2018
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