Individual
MR. MANUEL LOPEZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
6700 CLARK RD, SARASOTA, FL 34241-9328
(815) 519-4448
Mailing address
2725 N ELMWOOD AVE, WAUKEGAN, IL 60087-3064
(815) 519-4448
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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