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Individual

MS. KIM S. O'CONNELL-BROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1815 WELLS STREET, 2ND FLOOR, LAS CRUCES, NM 88005
(505) 646-5744
Mailing address
800 CHATEAU DR, LAS CRUCES, NM 88005-1534
(505) 647-5108

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
152
NM

Other

Enumeration date
08/16/2006
Last updated
07/08/2007
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