Individual
VICTOR LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3235 MAIN AVE, DURANGO, CO 81301-4258
(970) 259-3110
(970) 259-6605
Mailing address
3235 MAIN AVE, DURANGO, CO 81301-4258
(970) 259-3110
(970) 259-6605
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21762
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01217629
—
CO
Enumeration date
03/06/2007
Last updated
07/08/2007
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