Most Relevant Information
Provider Data
| NPI Number: | 1003544735 |
| Provider Name: | KYONG A SHOCK |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/10/2022 |
| Last Updated: | 08/10/2022 |
Provider Practice Location
1355 GARDEN OF THE GODS RD STE 150
COLORADO SPRINGS
CO
809073595
Practice Location Phone/Fax
| Phone: | 7192126535 |
| Fax: |
Provider Mailing Location
1060 HARTELL DR
COLORADO SPRINGS
CO
809113512
Provider Mailing Phone/Fax
| Phone: | 7193180578 |
| Fax: |