Organization
LOPEZ IN
Active
Organization
LOPEZ IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LOPEZ (OWNER)
(405) 640-3479
Entity
Organization
Contact information
Practice address
1571 SW 43RD ST, OKLAHOMA CITY, OK 73119-4053
(405) 640-3479
Mailing address
1571 SW 43, OKLAHOMA, OK 73119
(405) 640-3479
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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