Individual
MRS. ELBA M LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
318 S. FIRST STREET, LAKE WALES, FL 33853
(863) 676-0353
Mailing address
31 PIAR RD, BABSON PARK, FL 33827
(863) 676-0353
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA-27399
FL
Other
Enumeration date
05/28/2010
Last updated
05/28/2010
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