Maryann Brock, PT
Individual provider Active NPI Physical Therapist · Zachary, LA
NPI 1306176409 · NPPES record last updated Jan 12, 2010
Key facts
- NPI
- 1306176409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 07478 (LA)
- Practice address
- 2335 Church St
Suite G
Zachary, LA 70791-2700 - Phone
- (225) 654-8208
- Fax
- (225) 654-4642
- NPI assigned
- Jan 12, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07478 | LA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 07478 | LA | Yes |
Addresses
Primary practice location
2335 Church St
Suite G
Zachary, LA 70791-2700
Mailing address
2335 Church St
Suite G
Zachary, LA 70791-2700
Phone (225) 654-8208
Other providers in Zachary, LA
- Bridge Builders Consultants, LLC
- Bridge Builders Consultants, LLC
- Bridge Builders Consultants, LLC
- Bridges of Love, LLC
- Lisa Broadnax
- Camryn Brouillette
- Kirsten Brouillette
- Bailey Michelle Broussard
- Michael Broussard
- Clayton G Brown
All providers in Zachary, LA · Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.