Brock, Luther Green
Brock, Luther Green is an individual health care provider with primary practice located at 8007 N Point Blvd Suite F, Winston Salem NC 27106-3268. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter, which is considered as his primary health care specialty. Brock, Luther Green can be contacted via phone (336) 896-0408.Contact Information
Primary practice address
8007 N Point Blvd Suite F
Winston Salem NC 27106-3268
Phone: (336) 896-0408
Fax: (336) 896-0409
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter | 225000000X | CFTS0684 | |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter | 225000000X | CFO02049 |
Profile Details
| NPI number | 1821145400 |
|---|---|
| LBN Legal business name | Brock, Luther Green |
| Credentials | CFTS, CFO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2007 |
| Last updated | Feb 12th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821145400 | NPPES |
| North Carolina | MEDICAID | 7795387 | |
| North Carolina | MEDICAID | 7795178 |
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