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Individual

MARTY JACOB BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
7 RIVERS DR STE 10&20, HATTIESBURG, MS 39401-1323
(601) 909-5006
(601) 909-5008
Mailing address
8 DEER RDG, PETAL, MS 39465-8713
(601) 543-9018

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6673
MS

Other

Enumeration date
11/06/2019
Last updated
01/04/2023
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