Individual
ALEXANDRA JEAN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(843) 792-4074
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(843) 792-4074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL84521
SC
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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