Individual
GRACE SHOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14351 KUTZTOWN RD, FLEETWOOD, PA 19522-9273
(610) 944-8800
Mailing address
2100 MACK BLVD, ALLENTOWN, PA 18103-5622
(484) 884-4500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA064117
PA
Other
Enumeration date
10/17/2022
Last updated
01/15/2025
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