Individual
KELLY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6700 FRANCE AVE S STE 300, EDINA, MN 55435-1908
(952) 345-3000
Mailing address
6700 FRANCE AVE S STE 300, EDINA, MN 55435-1908
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105763
MN
Other
Enumeration date
01/15/2019
Last updated
11/03/2020
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