Individual
MS. BLANCA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2511 N JOHN YOUNG PKWY, KISSIMMEE, FL 34741-1653
(407) 483-7961
Mailing address
2511 N JOHN YOUNG PKWY, KISSIMMEE, FL 34741-1653
(407) 483-7961
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19643
FL
Other
Enumeration date
01/23/2007
Last updated
12/08/2015
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