Individual
LEE R BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4304 LAFAYETTE BLVD, FREDERICKSBURG, VA 22408-4234
(540) 891-4444
(540) 891-9034
Mailing address
4304 LAFAYETTE BLVD, FREDERICKSBURG, VA 22408-4234
(540) 891-4444
(540) 891-9034
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101032219
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6398707
—
VA
Enumeration date
07/06/2006
Last updated
01/23/2024
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