Individual
CARLA ROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2601 FERRY ST, LAFAYETTE, IN 47904-3061
(765) 448-8000
(765) 448-8335
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002802A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000188965
ANTHEM PROVIDER NUMBER
IN
05
—
100097670
—
IN
01
—
9269054
PHCS PID NUMBER
IN
Enumeration date
03/21/2006
Last updated
06/07/2012
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