Individual
MARTHA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7010 E CHAUNCEY LN STE 210, PHOENIX, AZ 85054-3115
(602) 277-1117
Mailing address
5931 W GRANADA RD, PHOENIX, AZ 85035-4836
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
AZ
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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