Organization
MICHAEL E. BROCK, D.O., P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EUGENE BROCK D.O. (OWNER)
(606) 326-0640
Entity
Organization
Contact information
Practice address
2920 WINCHESTER AVE, SUITE 1, ASHLAND, KY 41101-1962
(606) 326-0640
(606) 326-0650
Mailing address
2920 WINCHESTER AVE, SUITE 1, ASHLAND, KY 41101-1962
(606) 326-0640
(606) 326-0650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64081540
—
KY
Enumeration date
07/12/2007
Last updated
04/15/2008
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