| Nancy Dock Llc | |
|
549 Maryland Ave Ne Grand Rapids MI 49503-2106 | |
| (616) 334-9334 | |
| Not Available |
| Full Name | Nancy Dock Llc |
|---|---|
| Speciality | Social Worker |
| Location | 549 Maryland Ave Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Nancy Dock (SOCIAL WORKER) |
| Authorized Official Contact | 6163349334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy Dock Llc 549 Maryland Ave Ne Grand Rapids MI 49503-2106 Ph: () - | Nancy Dock Llc 549 Maryland Ave Ne Grand Rapids MI 49503-2106 Ph: (616) 334-9334 |
| NPI Number | 1184279432 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 03/07/2023 |
| Certification Date | 02/06/2023 |
| Medicare PECOS PAC ID | 2264806405 |
|---|---|
| Medicare Enrollment ID | O20230329003046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184279432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nancy L Dock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023266301 PECOS PAC ID: 4183904550 Enrollment ID: I20161201001761 |
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