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Individual

MRS. DERENI BLAKE BROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
195 COMMERCIAL DR, STE 100, LONDON, KY 40744-5234
(606) 657-2354
(606) 657-2354
Mailing address
195 COMMERCIAL DR, STE 100, LONDON, KY 40744-5234
(606) 657-2354

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006310
KY

Other

Enumeration date
12/06/2013
Last updated
10/28/2019
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