Individual
MISS OLIVIA GRACE SOPKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
895 E MAIN ST, EPHRATA, PA 17522-2545
(717) 721-4585
(717) 721-4597
Mailing address
895 E MAIN ST, EPHRATA, PA 17522-2545
(717) 721-4585
(717) 721-4597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA006621
PA
363AM0700X
Medical Physician Assistant
Primary
MA064891
PA
363AM0700X
Medical Physician Assistant
Primary
OA006621
PA
Other
Enumeration date
07/25/2023
Last updated
03/03/2026
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