Provider Demographics
NPI:1184376725
Name:SOPIC, MAGGIE (DC)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:SOPIC
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-8314
Mailing Address - Country:US
Mailing Address - Phone:814-762-0211
Mailing Address - Fax:
Practice Address - Street 1:111 BOAL AVE
Practice Address - Street 2:
Practice Address - City:BOALSBURG
Practice Address - State:PA
Practice Address - Zip Code:16827-1444
Practice Address - Country:US
Practice Address - Phone:814-808-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor