Provider Demographics
NPI:1508937939
Name:ROCK, PAULA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:MARIE
Last Name:ROCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3324
Mailing Address - Country:US
Mailing Address - Phone:910-228-0771
Mailing Address - Fax:
Practice Address - Street 1:25 N HAMPSTEAD VILLAGE DR
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3932
Practice Address - Country:US
Practice Address - Phone:910-270-6026
Practice Address - Fax:910-270-6028
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ38913AMedicare PIN