Individual
AMANDA ROSE JOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 744-4591
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
023843
NY
Other
Enumeration date
09/28/2019
Last updated
09/28/2019
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