Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kristie Lyn Brock, PTA

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1033762240

Kristie Lyn Brock, PTA is a Physical Medicine & Rehabilitation Physician in Salem, Oregon. Licensed in Michigan. Registered with an NPI since 2019.

Licensed in
MI
In the registry since
2019
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1750 McGilchrist St SE Ste 130
Salem, OR 97302-1691
Phone: (971) 304-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 5502001181 (MI)

Record details

NPI number1033762240
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJuly 17, 2019
Last updated in NPPESJuly 17, 2019

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