| NPI | 1750360699 |
|---|---|
| Other Name | SHOCK THOMAS GEN PTR |
| Entity Type | Organization |
| Authorized Contact | KERRY LYN MYERS Office Manager 209-334-0429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E3467) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E3241) |
| 213ER0200X Podiatrist, Radiology (Licence: CA E3241) | |
| 213ER0200X Podiatrist, Radiology (Licence: CA E3467) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E3241) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E3467) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2015-11-12 |