Organization
MY PRACTITONER FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY SUE BROCK NP (OWNER)
(513) 748-0874
Entity
Organization
Contact information
Practice address
2996 STATE ROUTE 132, AMELIA, OH 45102-2404
(513) 748-0874
(513) 322-7989
Mailing address
2996 STATE ROUTE 132, AMELIA, OH 45102-2404
(513) 748-0874
(513) 322-7989
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
COA.13223-NP
OH
Other
Enumeration date
12/19/2012
Last updated
07/19/2013
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