Provider Demographics
NPI:1114786928
Name:BROCK INTEGRATIVE HEALTH INC
Entity Type:Organization
Organization Name:BROCK INTEGRATIVE HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:MELI
Authorized Official - Middle Name:N
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:AP, DOM, LMT
Authorized Official - Phone:941-504-8983
Mailing Address - Street 1:11270 82ND ST E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2705
Mailing Address - Country:US
Mailing Address - Phone:941-504-8983
Mailing Address - Fax:
Practice Address - Street 1:11270 82ND ST E
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2705
Practice Address - Country:US
Practice Address - Phone:941-504-8983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROCK INNOVATIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty