Individual
MS. DENIESE EARLENE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2225 OLD EMMORTON RD STE 210, BEL AIR, MD 21015-6123
(410) 569-0990
(410) 515-0777
Mailing address
7403 BRIXWORTH CT UNIT 101, WINDSOR MILL, MD 21244-5670
(302) 750-1785
(443) 316-8641
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24520
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000041626
—
DE
Enumeration date
11/15/2005
Last updated
01/24/2019
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