Individual
BROCK GOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC
Contact information
Practice address
4200 32ND AVE S, FARGO, ND 58104-8952
(701) 234-8700
Mailing address
4200 32ND AVE S, FARGO, ND 58104-8952
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2646
ND
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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