Individual
SHAUN MICHAEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1799 STUMPF BLVD, BUILDING 1, SUITE4, GRETNA, LA 70056
(504) 365-1020
(504) 365-1080
Mailing address
1799 STUMPF BLVD, BUILDING 1, SUITE4, GRETNA, LA 70056
(504) 365-1020
(504) 365-1080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
07082
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07082
LA PT LICENSE #
LA
Enumeration date
02/13/2007
Last updated
07/08/2007
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