Individual
GUERRERO IVAN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 E HIGHWAY 36, SMITH CENTER, KS 66967-9582
(785) 282-6834
(785) 282-6331
Mailing address
PO BOX 349, SMITH CENTER, KS 66967-0349
(785) 262-6834
(785) 282-6331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02397
KS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/30/2020
Last updated
06/17/2024
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