Most Relevant Information
Provider Data
| NPI Number: | 1003522970 |
| Provider Name: | JONATHAN SCOTT BROCK |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/25/2023 |
| Last Updated: | 01/25/2023 |
Provider Practice Location
177 BURT RD STE B
LEXINGTON
KY
405032457
Practice Location Phone/Fax
| Phone: | 8596879725 |
| Fax: |
Provider Mailing Location
177 BURT RD STE B
LEXINGTON
KY
405032457
Provider Mailing Phone/Fax
| Phone: | 8596879725 |
| Fax: |