Individual
TANYA JO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 3RD AVE, KEARNEY, NE 68845-5913
(308) 708-0655
Mailing address
1620 3RD AVE, KEARNEY, NE 68845-5913
(308) 708-0655
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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