Individual
MISS ALYSSA ANN SHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DOCTORAL STUDENT
Contact information
Practice address
1695 MAIN ST, SUITE 400, SPRINGFIELD, MA 01103-1063
(413) 739-5572
Mailing address
156 BROOK ST, DUMONT, NJ 07628-2425
(201) 527-0902
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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