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1053876623
BROCK WOLFORD
LOGAN, OH
NPI
1053876623
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OH 169242)
Enumeration Date
2019-02-07
Last Update Date
2019-02-07
Business Address
BROCK WOLFORD CDCA
30663 RED ROCK CT # 1
LOGAN, OH 43138-9672
Phone number: 740-888-1377
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Mailing Address
BROCK WOLFORD CDCA
30663 RED ROCK CT # 1
LOGAN, OH 43138-9672
Phone number: 740-888-1377
Copy
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