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Individual

MR. JAIME LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
3490 NORTH RIDGE RD., SUITE 290, ELLICOTT CITY, MD 21043
(410) 750-9006
Mailing address
2722 GREAT LAKES AVE, SUGAR LAND, TX 77479-2078
(281) 494-4896

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3484
NM

Other

Enumeration date
11/24/2008
Last updated
11/24/2008
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