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Individual

CARSON LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1705 S SAN FRANCISCO ST, FLAGSTAFF, AZ 86011-9206
(817) 879-3923
Mailing address
1651 N GEMINI DR APT 22, FLAGSTAFF, AZ 86001-1609

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-100214
AZ

Other

Enumeration date
08/15/2022
Last updated
07/23/2025
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