Shoshana B Church, PA

NPI #1548261449 in Carterville, Illinois

Provider Information

NPI Number: 1548261449
Entity Type: Individual
Name: Shoshana B Church, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Aug 2, 2005
Last Updated: Sep 13, 2012

Practice Location

Address: 1006 SOUTH DIVISION STREET
City: Carterville
State: Illinois
ZIP Code: 62918-1539
Phone: (618) 985-4841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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