Individual
MIKALAH ANN BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
6731 NE STATE RTE E, WEATHERBY, MO 64497-5500
(816) 449-0870
Mailing address
6731 NE STATE RTE E, WEATHERBY, MO 64497-5500
(816) 449-0870
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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