Most Relevant Information
Provider Data
| NPI Number: | 1003670225 |
| Provider Name: | BRENDEN WOCKLEY PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | OA006787 |
Most Important Dates
| Enumeration Date: | 02/08/2024 |
| Last Updated: | 02/08/2024 |
Provider Practice Location
631 N BROAD STREET EXT
GROVE CITY
PA
161274603
Practice Location Phone/Fax
| Phone: | 7244507000 |
| Fax: |
Provider Mailing Location
1620 LILAC LN
CRESCENT
PA
150463812
Provider Mailing Phone/Fax
| Phone: | 7244571238 |
| Fax: |