Brock, Marty Dewayne

Brock, Marty Dewayne is an sole proprietor health care provider with primary practice located at 214 Prosperity Church Rd , Bainbridge GA 39817-8278. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Pastoral. Behavioral Health & Social Service Providers / Pastoral is his primary health care specialty. Brock, Marty Dewayne can be contacted via phone (229) 220-2275.

Contact Information

Primary practice address
214 Prosperity Church Rd Bainbridge GA 39817-8278
Phone: (229) 220-2275
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X C0115 Georgia
Behavioral Health & Social Service Providers / Pastoral 101YP1600X 10114352 Georgia

Profile Details

NPI number 1427485036
LBN Legal business name Brock, Marty Dewayne
Credentials M.A., CCAADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2013
Last updated Sep 27th, 2013 - about 11 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.

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