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Organization
LUCILLE LOPEZ WAGNER R.P.T., INC.
Active
Organization
LUCILLE LOPEZ WAGNER R.P.T., INC.
Active
Other names
Orange Coast Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUCILLE LOPEZ WAGNER P.T., L.AC. (PRESIDENT)
(714) 841-2688
Entity
Organization
Contact information
Practice address
17456 BEACH BLVD, HUNTINGTON BEACH, CA 92647-5913
(714) 841-2688
(714) 841-2688
Mailing address
3079 NESTALL RD, LAGUNA BEACH, CA 92651-2026
(949) 497-8227
(714) 841-2688
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT6997
CA
Other
Enumeration date
05/15/2007
Last updated
08/29/2010
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