Shannon Bock, PA-C
Physician Assistant in Broomfield, CO. Individual provider (NPI-1).
NPI number1083662225
StatusActive
Last updated in NPPESMay 18, 2020
Details
- NPI
- 1083662225
- Entity type
- Individual (NPI-1)
- Name
- Shannon Bock
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 4, 2006
- Certification date
- May 18, 2020
- Last updated
- May 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 1528 | CO | Yes |
Practice location
403 Summit BlvdSte 201
Broomfield, CO 80021
Phone 303-429-6448 · Fax 303-951-3701
Mailing address
12596 W Bayaud AveSte 205
Lakewood, CO 80228-2018
Phone 720-713-1885
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