Provider Demographics
NPI:1164862231
Name:ROCKS, JOAN (PHD, ATC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:ROCKS
Suffix:
Gender:F
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4621 N STATE ROUTE 61
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-9641
Mailing Address - Country:US
Mailing Address - Phone:740-965-0864
Mailing Address - Fax:
Practice Address - Street 1:160 CENTER ST
Practice Address - Street 2:RIKE CENTER
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1405
Practice Address - Country:US
Practice Address - Phone:614-823-3505
Practice Address - Fax:614-823-1966
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0004322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer