Provider Demographics
NPI:1821494949
Name:BROCK, PHILIP (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:BROCK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 BLEACHERY BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8317
Mailing Address - Country:US
Mailing Address - Phone:828-684-3611
Mailing Address - Fax:
Practice Address - Street 1:1201 BLEACHERY BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8317
Practice Address - Country:US
Practice Address - Phone:828-684-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist