Individual
TARA LYNN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4420
(563) 584-4295
Mailing address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4100
(563) 584-4110
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000786
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0475020
—
IA
Enumeration date
05/12/2006
Last updated
01/12/2011
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