Individual
MICHELE SUSAN BOOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2813 INDUSTRIAL PARK RD STE C, MIFFLINTOWN, PA 17059-9078
(717) 436-8283
(717) 436-8351
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA002251
PA
363AM0700X
Medical Physician Assistant
Primary
MA051693
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031813050002
—
PA
Enumeration date
05/23/2006
Last updated
04/13/2022
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