Individual
TREA ANN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 KOLBE RD, LORAIN, OH 44053-1611
(440) 323-8515
Mailing address
860 E BROAD STREET, SUITE I, ELYRIA, OH 44035-6542
(440) 323-8515
(440) 323-7900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
259599
OH
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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