Individual
HEATHER PAULINE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1673 W SHORELINE DR STE 230, BOISE, ID 83702-6752
(208) 343-4700
(208) 343-4706
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 960-0935
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3958
ID
225100000X
Physical Therapist
PTL-10035
CO
Other
Enumeration date
07/03/2008
Last updated
08/18/2021
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