Individual
GUADALUPE SANTOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
395 ROUTE 70 STE 202, LAKEWOOD, NJ 08701-6161
(732) 639-5408
Mailing address
321 AYCRIGG AVE FL 2, PASSAIC, NJ 07055-3711
(862) 290-7235
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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