Brock, Tara Lynn

Brock, Tara Lynn is an individual health care provider with primary practice located at 1500 Associates Dr , Dubuque IA 52002-2201. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Brock, Tara Lynn can be contacted via phone (563) 584-4420.

Contact Information

Primary practice address
1500 Associates Dr Dubuque IA 52002-2201
Phone: (563) 584-4420
Fax: (563) 584-4295
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 000786 Iowa

Profile Details

NPI number 1164472783
LBN Legal business name Brock, Tara Lynn
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jan 12th, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164472783 NPPES
Iowa MEDICAID 0475020

Popular Providers