Individual
NICHOLAS COLBY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
4015 2ND AVE STE B, SUMMERVILLE, SC 29486-7882
(843) 376-3996
Mailing address
50 CENTRAL ISLAND ST UNIT 459, DANIEL ISLAND, SC 29492-6806
(703) 987-7283
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5558
SC
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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