Individual
JAMES JOSEPH SHOCK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
307 LAIRD STREET, REAR, WILKES-BARRE, PA 18702
(570) 408-9320
(570) 408-9324
Mailing address
307 LAIRD STREET, REAR, WILKES BARRE, PA 18702
(570) 408-9320
(570) 408-9324
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/18/2009
Last updated
11/19/2009
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