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Individual

JONATHAN JACOB BOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
17233 N HOLMES BLVD, STE 1650, PHOENIX, AZ 85053-2018
(602) 467-8612
(602) 467-8677
Mailing address
17233 N HOLMES BLVD, STE 1650, PHOENIX, AZ 85053-2018
(602) 467-8612
(602) 467-8677

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5813
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
722068
AZ
Enumeration date
08/25/2006
Last updated
07/08/2007
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