Most Relevant Information
Provider Data
| NPI Number: | 1003043803 |
| Provider Name: | SHANNON K ALSOP DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | OT012985 |
Most Important Dates
| Enumeration Date: | 06/18/2009 |
| Last Updated: | 10/13/2020 |
Provider Practice Location
150 S WARNER RD STE 310
KING OF PRUSSIA
PA
194062860
Practice Location Phone/Fax
| Phone: | 7732924800 |
| Fax: | 3125644059 |
Provider Mailing Location
1340 S DAMEN AVE
SUITE 400
CHICAGO
IL
606081169
Provider Mailing Phone/Fax
| Phone: | 7732924800 |
| Fax: | 3125644059 |