Individual
SHANNON BOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
403 SUMMIT BLVD, STE 201, BROOMFIELD, CO 80021
(303) 429-6448
(303) 951-3701
Mailing address
12596 W BAYAUD AVE, STE 205, LAKEWOOD, CO 80228-2018
(720) 713-1885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1528
CO
Other
Enumeration date
05/04/2006
Last updated
05/18/2020
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