Provider Demographics
NPI:1225407356
Name:BROCK, DEBORAH D (DPT)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:D
Last Name:BROCK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 JIM BERRY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-8660
Mailing Address - Country:US
Mailing Address - Phone:828-369-7878
Mailing Address - Fax:828-369-8760
Practice Address - Street 1:235 JIM BERRY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-8660
Practice Address - Country:US
Practice Address - Phone:828-369-7878
Practice Address - Fax:828-369-8760
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15726174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist