Individual
MR. EDMOND BERNARD BOCK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
190 LAKE DR, ATCO, NJ 08004-3013
(856) 210-6231
Mailing address
190 LAKE DR, ATCO, NJ 08004-3013
(856) 210-6231
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09056000
NJ
Other
Enumeration date
04/06/2007
Last updated
06/07/2009
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