Individual
MA. ESTELA LOPEZ ORTALEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2700 E 34TH ST, JOPLIN, MO 64804-4310
(417) 781-1737
Mailing address
2810 S JACKSON AVE, JOPLIN, MO 64804-2524
(417) 624-2061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2007018572
MO
Other
Enumeration date
09/24/2007
Last updated
07/05/2015
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