Individual
JOAN BROCK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1801 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 802-0780
(706) 802-0786
Mailing address
1801 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 802-0780
(706) 802-0786
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001397
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1082149
FIRST HEALTH
—
01
—
21168648367
BEECHSTREET
—
01
—
5142439
AETNA
—
01
—
655245
BCBS
GA
Enumeration date
08/11/2005
Last updated
07/08/2007
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