Individual
MS. CRISSIE ALAYNE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.- C
Contact information
Practice address
2800 VILLAGE RD, # 108, GRANBURY, TX 76049-4193
(817) 573-0444
Mailing address
930 SE 4TH ST, GRAND PRAIRIE, TX 75051-3221
(817) 271-7425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TX
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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