Individual
JEREMIAH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1651 W GRANT RD, TUCSON, AZ 85745-1433
(520) 571-8600
(520) 571-8700
Mailing address
PO BOX 27669, TUCSON, AZ 85726-7669
(520) 571-8600
(520) 571-8700
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/19/2013
Last updated
01/23/2014
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