Provider Demographics
NPI:1164489407
Name:ROCK, MICHAEL KEITH (PHD PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:KEITH
Last Name:ROCK
Suffix:
Gender:M
Credentials:PHD PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17326 HWY 3
Mailing Address - Street 2:PROGRESSIVE PHYSICAL THERAPY
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-332-3000
Mailing Address - Fax:281-332-9171
Practice Address - Street 1:17326 HWY 3
Practice Address - Street 2:PROGRESSIVE PHYSICAL THERAPY
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-332-3000
Practice Address - Fax:281-332-9171
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1073823225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83711TOtherBCBS