Individual
JASON D. MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
250 CETRONIA ROAD, SUITE303, ALLENTOWN, PA 18104-9168
(610) 973-6200
(610) 973-6535
Mailing address
PO BOX 848269, BOSTON, MA 02284-8269
(610) 973-1700
(610) 973-1778
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC008034
PA
225XH1200X
Hand Occupational Therapist
Primary
OC008034
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50058870
CAPITAL BLUE CROSS
PA
Enumeration date
06/02/2006
Last updated
07/31/2009
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