Individual
EDWARD MATTHEW LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
116 E PINE ST, CLEARFIELD, PA 16830-2541
(814) 765-6579
(814) 765-6570
Mailing address
116 E PINE ST, CLEARFIELD, PA 16830-2541
(814) 765-6579
(814) 765-6570
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000025
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001479858 0002
—
PA
Enumeration date
08/04/2006
Last updated
10/01/2015
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