Provider Demographics
NPI:1508918053
Name:BOCK, SETH (DA)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:
Last Name:BOCK
Suffix:
Gender:M
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:850 AQUIDNECK AVE
Mailing Address - Street 2:UNIT A3
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-7244
Mailing Address - Country:US
Mailing Address - Phone:401-849-0514
Mailing Address - Fax:
Practice Address - Street 1:850 AQUIDNECK AVE
Practice Address - Street 2:UNIT A3
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-7244
Practice Address - Country:US
Practice Address - Phone:401-849-0514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RID.A. 000180171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist