Most Relevant Information
Provider Data
| NPI Number: | 1003569195 |
| Provider Name: | NINA MARIE BOCK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 5601011004 |
Most Important Dates
| Enumeration Date: | 01/30/2022 |
| Last Updated: | 07/24/2023 |
Provider Practice Location
205 N EAST AVE
JACKSON
MI
492011753
Practice Location Phone/Fax
| Phone: | 2489905924 |
| Fax: |
Provider Mailing Location
205 N EAST AVE
JACKSON
MI
492011753
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |