IndividualActive
Jessica Brock
NPI 1962636233 · Radiologic Technologist · Mandeville, LA
Provider details
- NPI number
- 1962636233
- Entity type
- Individual
- Primary specialty
- Radiologic TechnologistTechnologists, Technicians & Other Technical Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 5969 (LA)
Mailing address
169 Highland Dr
Mandeville, LA 70471
Registry dates
- Enumerated
- 2009-05-14
- Last updated
- 2009-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.