Individual
DR. MASON MICHAEL SOPCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5 EVERGREEN ST, DRYDEN, NY 13053-0000
(607) 844-8181
(607) 844-4288
Mailing address
4185 GARRETT RD, ITHACA, NY 14850-9564
(607) 427-6728
(607) 844-4288
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
L1594796
MI
207Q00000X
Family Medicine Physician
Primary
L1594796
MI
Other
Enumeration date
10/06/2009
Last updated
09/27/2013
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