Individual
MS. RUBY A BROCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5920 PINE WILD DR, WESTERVILLE, OH 43082-9723
(614) 865-0579
Mailing address
5920 PINEWILD DRIVE, WESTERVILLE, OH 43082-9723
(614) 865-0579
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
SV105660
OH
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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