Provider Demographics
NPI:1588970487
Name:SANDE, BROCK W (CP)
Entity type:Individual
Prefix:
First Name:BROCK
Middle Name:W
Last Name:SANDE
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
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Mailing Address - Street 1:949 STEVENS DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3508
Mailing Address - Country:US
Mailing Address - Phone:509-946-2520
Mailing Address - Fax:509-946-2530
Practice Address - Street 1:949 STEVENS DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3508
Practice Address - Country:US
Practice Address - Phone:509-946-2520
Practice Address - Fax:509-946-2530
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist