Individual
DENISE RENEE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C.
Contact information
Practice address
140 115TH ST E, TACOMA, WA 98445-1714
(813) 500-1141
Mailing address
140 115TH ST E, TACOMA, WA 98445-1714
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1965
FL
246Z00000X
Other Specialist/Technologist
A1 60339447
WA
Other
Enumeration date
05/31/2011
Last updated
04/14/2015
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