Individual
BREANNA BOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2456 FOSTER AVE NE, GRAND RAPIDS, MI 49505-3650
(616) 886-4885
Mailing address
2456 FOSTER AVE NE, GRAND RAPIDS, MI 49505-3650
(616) 886-4885
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86043515
MI
Other
Enumeration date
02/03/2015
Last updated
07/15/2024
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