Individual
DAWN ASTRID BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
924 E JACKSON ST, MEDFORD, OR 97504-7025
(949) 345-9191
Mailing address
1316 MAGRUDER CT, CENTRAL POINT, OR 97502-4821
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023219
OR
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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