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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