Individual
BROCK MONGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T
Contact information
Practice address
230 SW 5TH ST, MADRAS, OR 97741-1341
(541) 475-1218
(541) 475-7647
Mailing address
230 SW 5TH ST, MADRAS, OR 97741-1341
(541) 475-1218
(541) 475-7647
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4945893-2401
UT
225100000X
Physical Therapist
Primary
5164
OR
Other
Enumeration date
08/23/2005
Last updated
07/08/2007
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