Individual
MA. CARMELA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
141 COUNTRY ESTATES BLVD, VIDALIA, GA 30474-8207
(912) 531-1541
Mailing address
141 COUNTRY ESTATES BLVD, VIDALIA, GA 30474-8207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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