Individual
ELVA L LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075
Mailing address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2111246
TX
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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