Individual
RYAN JAMES LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3749 SHERMAN AVE, MONTE VISTA, CO 81144-9403
(719) 852-5118
Mailing address
3749 SHERMAN AVE, MONTE VISTA, CO 81144-9403
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0014590
CO
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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