Individual
KEANA NYASIA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
19 W ALLENS LN APT 17, PHILADELPHIA, PA 19119-1640
(347) 510-6192
Mailing address
19 W ALLENS LN APT 17, PHILADELPHIA, PA 19119-1640
(347) 510-6192
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG014347
PA
Other
Enumeration date
03/17/2022
Last updated
03/17/2022
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