Individual
MRS. JAMIE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
59 FLEMING DR, INDEPENDENCE, KY 41051-8515
(859) 414-5415
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
05729
OH
224Z00000X
Occupational Therapy Assistant
A5875
KY
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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