Individual
ANNE E LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
(781) 306-5379
Mailing address
147 MILK ST, PROVIDER ENROLLMENT DEPARTMENT - 9THFLOOR, BOSTON, MA 02109-4806
(617) 421-2508
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4028
MA
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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