Individual
ANDREA LYNN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
900 N. UNIVERSITY AVE, ROOM B63, WEST LAFAYETTE, IN 47907
(765) 494-3245
Mailing address
3860 LEDYARD ST., WEST LAFAYETTE, IN 47906
(765) 418-5102
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001327A
IN
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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