Individual
LAUREN BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
108 N MAIN ST, BOGARD, MO 64622-7124
(660) 973-3074
Mailing address
108 N MAIN ST, BOGARD, MO 64622-7124
(660) 973-3074
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2017035789
MO
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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