| Doctor Name: | MR. KRISTOFER L BROCK |
| NPI Number: | 1730491895 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S. CCC-SLP |
| License Number: | 18114 |
| Business Practice Address: | 3601 4th St Lubbock, TX - 794300002 |
| Business Phone Number: | 8067435660 |
| Business Fax Number: | |
| Mailing Address: | 406 W Mayfair Ave, STOCKTON |
| State: | CA |
| Postal Code: | 952075113 |
| Phone Number: | 2096073540 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2010 |
| NPI Last Update Date: | 07/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 18114 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |