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Individual

REBECCA KATHERINE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT,DPT

Contact information

Practice address
200 WEESE ST, ELKINS, WV 26241-3758
(770) 656-4776
Mailing address
673 BLACKBERRY RUN TRL, DALLAS, GA 30132-2128
(770) 656-4776

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT004319
WV
225100000X
Physical Therapist
Primary
PT013994
GA

Other

Enumeration date
06/17/2019
Last updated
09/30/2020
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