Individual
MARRISELA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3848 HARRISON BLVD, OGDEN, UT 84408-0001
(801) 626-6000
Mailing address
3848 HARRISON BLVD, OGDEN, UT 84408-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
UT
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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