Individual
BROCK R LASURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1103 GALVIN RD S STE G, BELLEVUE, NE 68005-3000
(402) 292-1072
(402) 292-0742
Mailing address
1103 GALVIN RD S STE G, BELLEVUE, NE 68005-3000
(402) 292-1072
(402) 292-0742
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22937
NE
Other
Enumeration date
05/28/2006
Last updated
03/13/2012
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