Individual
GEENA RAE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3571 NW MCCREADY DR, BEND, OR 97703-8650
(209) 985-2940
Mailing address
3571 NW MCCREADY DR, BEND, OR 97703-8650
(209) 985-2940
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64258
OR
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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