Individual
TREVOR LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6525 2ND AVE, DETROIT, MI 48202-3006
(313) 972-4060
Mailing address
6525 2ND AVE, DETROIT, MI 48202-3006
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001214
MI
Other
Enumeration date
03/31/2014
Last updated
03/31/2014
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