Provider Demographics
NPI:1295069300
Name:ROCK, NICOLE (ATC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ROCK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:11945 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1613
Mailing Address - Country:US
Mailing Address - Phone:904-880-2424
Mailing Address - Fax:904-880-2420
Practice Address - Street 1:9191 R G SKINNER PKWY
Practice Address - Street 2:SUITE 703
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9655
Practice Address - Country:US
Practice Address - Phone:904-854-7474
Practice Address - Fax:904-854-7470
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer