Individual
ERIC TYLER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 220, BRIDGEPORT, WV 26330-0220
(304) 933-3073
Mailing address
PO BOX 220, BRIDGEPORT, WV 26330-0220
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1804
WV
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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