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Individual

KRISTIN ANNE PROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9500 EUCLID AVE, M2 ANNEX, CLEVELAND, OH 44195-0001
(216) 444-0933
(216) 444-8530
Mailing address
9500 EUCLID AVE, M2 ANNEX, CLEVELAND, OH 44195-7112
(216) 444-0933
(216) 444-8530

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.009916
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3109675
OH
Enumeration date
05/05/2008
Last updated
03/17/2011
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