Individual
ENGELBERTH ALEXANDER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7901 W MISSOURI AVE, GLENDALE, AZ 85303-5005
(623) 688-6725
Mailing address
7901 W MISSOURI AVE, GLENDALE, AZ 85303-5005
(623) 688-6725
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-28768
AZ
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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