Individual
DR. BROCK ALLEN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,DPT
Contact information
Practice address
705 N MERIDIAN ST, GREENTOWN, IN 46936-1246
(765) 628-3377
Mailing address
2548 S 900 E, GREENTOWN, IN 46936-9204
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013068A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
12/01/2021
Last updated
12/01/2021
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