Individual
JOHN LAWRENCE BROCK, JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
521 OLD HODGENVILLE RD, GREENSBURG, KY 42743-9493
(270) 932-3226
Mailing address
130 SOUTHERN SCHOOL RD, SOMERSET, KY 42501-3223
(606) 679-4782
(606) 678-5296
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165874
KY
Other
Enumeration date
05/23/2006
Last updated
01/11/2017
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