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Individual

MRS. RHONDA K BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSN, RN, WOC, CFM

Contact information

Practice address
8007 N POINT BLVD, SUITE F, WINSTON SALEM, NC 27106-3268
(336) 896-0408
(336) 896-0409
Mailing address
PO BOX 11348, WINSTON SALEM, NC 27116-1348
(336) 896-0408
(336) 896-0409

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
052983
NC
224900000X
Mastectomy Fitter
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7795454
NC
Enumeration date
08/02/2006
Last updated
03/25/2011
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