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NPI Profile for RONDAL K BROCK in TAZEWELL, TN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI Number | 1811075088 |
|
| Status | Active | |
| Credentials | P.A.C. | |
| Entity | Individual | |
| Enumeration date | 11/02/2006 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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RONDAL K BROCK
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RONDAL K BROCK, P.A.C.