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1851991954
TERRY BROCK
VESTAVIA, AL
NPI
1851991954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AL 1-069351)
Enumeration Date
2020-10-28
Last Update Date
2020-10-28
Business Address
TERRY BROCK FNP
4232 CAHABA DR
VESTAVIA, AL 35243-1600
Phone number: 205-999-8788
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Mailing Address
TERRY BROCK FNP
4232 CAHABA DR
VESTAVIA, AL 35243-1600
Phone number: 205-999-8788
Copy
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TRANQUIL PATHWAY MENTAL WELLNESS, LLC