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Individual

SHANNON KOPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4921 W 18TH ST, LAWRENCE, KS 66047-2090
(785) 830-0100
(785) 830-0115
Mailing address
4921 W 18TH ST, LAWRENCE, KS 66047-2090
(785) 830-0100
(785) 830-0115

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
09/10/2018
Last updated
09/10/2018
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