Individual
DAVID BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 E MAIN ST., SPRING ARBOR, MI 49283
(248) 760-3641
Mailing address
106 E MAIN ST, SPRING ARBOR, MI 49283-9701
(248) 760-3641
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000170
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2601000170
SPORTS MEDICINE
MI
Enumeration date
08/23/2017
Last updated
07/21/2022
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