Individual
MR. RUDY J LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SO-IDC
Contact information
Practice address
JOINT SPECIAL OPERATIONS MEDICAL CTR, USAJFKSWCS STOP A., 3004 ARDENNES ST., FORT BRAGG, NC 28310-9610
(910) 369-7775
Mailing address
JOINT SPECIAL OPERATIONS MEDICAL CTR, USAJFKSWCS STOP A., 3004 ARDENNES ST., FORT BRAGG, NC 28310-9610
(910) 369-7775
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
NEC HM8403
NC
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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