Mrs Dereni Blake Brock, PT | |
195 Commercial Dr, Ste 100, London, KY 40744-5234 | |
(606) 657-2354 | |
(606) 657-2354 |
Full Name | Mrs Dereni Blake Brock |
---|---|
Gender | Female |
Speciality | Physical Therapy |
Experience | 11 Years |
Location | 195 Commercial Dr, London, Kentucky |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114358702 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 006310 (Kentucky) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Revolution Physical Therapy | 6507106812 | 3 |
Provider Name | Revolution Physical Therapy |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1992277107 PECOS PAC ID: 6507106812 Enrollment ID: O20190325001054 |
Mailing Address | Practice Location Address |
---|---|
Mrs Dereni Blake Brock, PT 195 Commercial Dr, Ste 100, London, KY 40744-5234 Ph: (606) 657-2354 | Mrs Dereni Blake Brock, PT 195 Commercial Dr, Ste 100, London, KY 40744-5234 Ph: (606) 657-2354 |
Dr. Nikolus Mckinley Blair, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1690 Highway 192 W, London, KY 40741 Phone: 606-877-3231 Fax: 606-877-3632 | |
Dr. Christopher Douglas Fuson, PT, DPT, ATC Physical Therapist Medicare: Medicare Enrolled Practice Location: 1690 Highway 192 W, London, KY 40741 Phone: 606-877-3231 Fax: 606-877-3632 | |
Mrs. Stephanie Leigh Griffie, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3104 Pine Top Rd, London, KY 40741 Phone: 606-862-8333 Fax: 606-862-8618 | |
Mr. Stephen Lambert Barton, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 803 Meyers Baker Rd, Suite 120, London, KY 40741 Phone: 606-878-1219 Fax: 606-877-1195 | |
Mr. Edward L Valentine Iii, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 195 Commercial Dr Ste 100, London, KY 40744 Phone: 606-657-5111 | |
Sarah Elizabeth Barrier, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 450 Hoskins Cemetery Rd, London, KY 40741 Phone: 606-682-3601 Fax: 606-864-2797 |