Individual
MR. THOMAS SPOCK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
33701 STATE ROAD 52, SAINT LEO, FL 33574
(352) 588-8112
Mailing address
PO BOX 6665, SAINT LEO, FL 33574-6665
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
4541
FL
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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