Individual
RONALD A. BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
311 E SPRUCE ST, GARDEN CITY, KS 67846
(620) 275-3030
(620) 275-3025
Mailing address
6001 SW 6TH AVE, SUITE 200, TOPEKA, KS 66615-1011
(785) 233-7491
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-01597
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
09/05/2006
Last updated
08/06/2018
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