Individual
LEAH M LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 SPRUCE ST, 4 SILVERSTEIN, PHILADELPHIA, PA 19104-4206
(215) 662-7870
Mailing address
3400 SPRUCE ST, 4 SILVERSTEIN, PHILADELPHIA, PA 19104-4206
(215) 662-7870
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054888
PA
Other
Enumeration date
08/05/2011
Last updated
03/08/2016
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