Individual
MRS. ANDREA GENTRY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
128 MEDICAL PARK RD, SUITE 101, MOORESVILLE, NC 28117-8578
(704) 658-1001
(704) 658-1002
Mailing address
128 MEDICAL PARK RD, SUITE 101, MOORESVILLE, NC 28117-8578
(704) 658-1001
(704) 658-1002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103497
NC
Other
Enumeration date
04/05/2006
Last updated
08/07/2023
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