Klock, George Bradley

Klock, George Bradley is an individual health care provider with primary practice located at 3200 Grand Ave , Des Moines IA 50312-4104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, which is considered as his primary health care specialty. Klock, George Bradley can be contacted via phone (515) 271-1722.

Contact Information

Primary practice address
3200 Grand Ave Des Moines IA 50312-4104
Phone: (515) 271-1722
Fax: (515) 271-1697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 1890 Arizona
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 1998 Iowa

Profile Details

NPI number 1104810001
LBN Legal business name Klock, George Bradley
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated May 23rd, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104810001 NPPES
Arizona Other AZ0064860 BCBS OF ARIZONA
Arizona MEDICAID 1104810001 BCBS OF ARIZONA

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