Provider Demographics
NPI:1417493107
Name:ROCK, JOHN (ATC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ROCK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CUNNINGHAM SQ
Mailing Address - Street 2:ATHLETICS-ALUMNI HALL
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02918-7001
Mailing Address - Country:US
Mailing Address - Phone:401-865-2262
Mailing Address - Fax:401-865-2965
Practice Address - Street 1:1 CUNNINGHAM SQ
Practice Address - Street 2:ATHLETICS-ALUMNI HALL
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02918-7001
Practice Address - Country:US
Practice Address - Phone:401-865-2262
Practice Address - Fax:401-865-2965
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer