Provider Demographics
NPI:1891763397
Name:SCHOCK, WINSLOW (DC)
Entity type:Individual
Prefix:
First Name:WINSLOW
Middle Name:
Last Name:SCHOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10470
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29731-0470
Mailing Address - Country:US
Mailing Address - Phone:803-366-6100
Mailing Address - Fax:803-366-4337
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5320
Practice Address - Country:US
Practice Address - Phone:803-366-6100
Practice Address - Fax:803-366-4337
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor