Individual
ZACHARY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 E LEWIS ST, FORT WAYNE, IN 46802-3139
(260) 426-3347
Mailing address
333 E LEWIS ST, FORT WAYNE, IN 46802-3139
(260) 426-3347
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39005477A
IN
Other
Enumeration date
08/25/2020
Last updated
09/29/2025
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