Individual
JISELLE MARIE BOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 W GROVER ST, SHELBY, NC 28150-3708
(704) 487-8591
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2019-01712
NC
2086S0102X
Surgical Critical Care Physician
Primary
2019-01712
NC
Other
Enumeration date
05/17/2012
Last updated
12/18/2023
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