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Individual

SAMANTHA MARIE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
116 E ROBERT S KERR BLVD, WYNNEWOOD, OK 73098-6621
(405) 665-4351
Mailing address
104 E SEMINOLE ST, WYNNEWOOD, OK 73098-6633

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
54225
OK

Other

Enumeration date
01/16/2018
Last updated
01/16/2018
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