Individual
BROCK MICHAEL RENKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1027 S MAIN ST STE 202, JOPLIN, MO 64801-4540
(417) 624-0050
Mailing address
444 FOUR STATES DR STE 1, GALENA, KS 66739-4325
(877) 783-4441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-03048
KS
363A00000X
Physician Assistant
5478
OK
363AM0700X
Medical Physician Assistant
2025006240
MO
Other
Enumeration date
08/02/2022
Last updated
06/08/2026
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