Individual
STEPHEN JOHN SHORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
59 HARRINGTON CT, COLCHESTER, CT 06415-1207
(860) 537-2339
Mailing address
20-42 PHILLIPS RD, LISBON, CT 06351-7000
(860) 376-5424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000919
CT
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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