KELLY BROCK

TERRE HAUTE, IN
NPI1992100275
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36002335A)
Enumeration Date2014-10-28
Last Update Date2014-10-28
Business Address
-- KELLY BROCK LAT, ATC
567 N 5TH ST
TERRE HAUTE, IN 47809-1903
Phone number: 812-237-2378
Mailing Address
-- KELLY BROCK LAT, ATC
567 N 5TH ST
TERRE HAUTE, IN 47809-1903
Phone number: