Individual
SHELBY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2083 15TH AVE, CAMERON, WI 54822-9785
(715) 296-4739
Mailing address
2083 15TH AVE, CAMERON, WI 54822-9785
(715) 296-4739
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2330-019
WI
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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