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Individual

SHELBY GLYNN STOCKTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
800 PLAZA DR STE 140, ROSTRAVER TOWNSHIP, PA 15012-4019
(724) 929-4122
Mailing address
22521 SPORTSMAN RD, SPARTANSBURG, PA 16434-3343
(412) 584-0730

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA063933
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/17/2022
Last updated
11/20/2022
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