Individual
GRICELDA P LOPEZ MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
Mailing address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 767-4235
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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