Individual
MR. MICHAEL EMANUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1776 E ROBINSON ST, NORMAN, OK 73071-7442
(405) 360-5600
Mailing address
301 N WALKER AVE APT 1203, OKLAHOMA CITY, OK 73102-1828
(787) 306-1776
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3182
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3182
PTA LICENSE
OK
Enumeration date
01/29/2020
Last updated
01/29/2020
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