Individual
KELLY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
610 S POLK ST, PAPILLION, NE 68046-2548
(402) 339-7700
Mailing address
610 S POLK ST, PAPILLION, NE 68046-2548
(402) 339-7700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
376
NE
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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