Individual
MRS. MADALYN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3526 DUTCHMANS LN, LOUISVILLE, KY 40205-3256
(502) 452-6331
Mailing address
3010 IRIS WAY, LOUISVILLE, KY 40220-1251
(502) 356-1888
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31005674A
IN
225X00000X
Occupational Therapist
Primary
R5885
KY
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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