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CORONEL EINNA-ERNEST LOPEZ DPT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1013252089

Individual Registrant:
 CORONEL EINNA-ERNEST LOPEZ DPT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
HWY 264 AND US 191  GANADO, AZ 86505 US
Tel: 928-755-4557  Fax: --

Contact information for business:
319 MCKEE DR  GALLUP, NM 87301-4823 US
Tel: 269-861-4630  Fax: --

Registration Information:
NPI: 1013252089
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
AZ10060

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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